Total Colectomy
Indications
• Injury
or lower GI bleeding where site cannot be located
• Ulcerative
colitis
• Multiple
cancers or polyps of the large bowel.
Position
Supine.
Anesthesia
General.
Procedure
1. Mobilize
right, transverse and left colon by incising lateral peritoneum. In benign
conditions, retain greater omentum. In malignancies separate it from the
stomach to take it with the colon.
2. Ligate
right colic, ileocolic, middle colic and inferior mesenteric vessels at their base.
3. Remove
divided bowel taking precautions to avoid spillage
4. Anastomose
terminal ileum to rectum using interrupted non-absorbable sutures in one layer.
5. Close
abdomen without drainage.
Instruments
• General
set, 1
• Gastrointestinal
set, 1
• Leylands
Jones clamp (Fig. 9.25).
Any questions be sent to drmmkapur@gmail.com
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