PROCEDURES 13

LEFT HEMICOLECTOMY

When is the procedure indicated?

Left Hemicolectomy is required in the following cases:

·       Tumours of the splenic flexure and descending colon

·       Diverticular disease with perforation or bleeding with the removal of part of transverse descending and sigmoid colon. 

Position of the patient

Supine.

 Anesthesia

General.

Surgical steps

·       Midline incision is given

·       The Descending colon and splenic flexure are mobilized.

·       The inferior mesenteric vessel is divided between ligatures at its take off.

·       The greater omentum is separated from the stomach to take it with the left half of the transverse colon.

·       Now colon is divided between clamps removing left lateral third of transverse colon and descending and sigmoid colon.

·       Then anastomose transverse colon to the rectum using a single layer of interrupted non-absorbable suture.

·       To avoid tension, it may be necessary to mobilise the right transverse colon.

·       The abdomen is closed without drainage.

Instruments

·       General set

·       Laparotomy set

·       Harrington splanchnic retractor

Peans intestinal forceps, 1 pair

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