Friday, October 3, 2014

Left Hemicolectomy


Left Hemicolectomy
Indications
•   Tumors of the splenic flexure and descending colon
•   Diverticular disease with perforation or bleeding.
Position
Supine.
Anesthesia
General.
Procedure
1.  Midline incision.
2.  Mobilize descending colon and splenic flexure.
3.  Divide the inferior mesenteric vessels between ligatures at its take off.
4.  Separate greater omentum from the stomach to take it with the left half of the transverse colon.
5.  Divide colon between clamps removing left lateral third of transverse colon.
6.  Descending and simoid colon.
7.  Anastomose transverse colon to the rectum using single layer of interrupted non-absorbable suture.
8.  To avoid tension, it may be necessary to mobilize the right transverse colon.
9.  Close abdomen without drainage.
Instruments
•   General set, 1
•   Gastrointestinal set, 1.
Any questions be sent to drmmkapur@gmail.com
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