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
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