TOTAL COLECTOMY
When is entire colon removed?
Entire colon is removed in the following cases:
.Injury
.Lower GIT bleeding where site cannot be located
.Ulcerative colitis
.Multiple cancers poly of the bowel
.Removal of right, transverse and descending colon.
Position of the patient
Supine.
Anaesthesia
General
SURGICAL Steps
.Mobilise the right , transverse and left colon by incising lateral peritoneum
(fig.2.31a).in benign conditions , retain the greater omentum.
In malignancies, separate it from the stomach and take it with the colon.
.Ligate the right Colic, Ileocolic, middle Colic and inferior mesenteric Vessels at their base.
.Remove the divided bowel taking precautions to avoid spillage.
.Anastomose terminal ileum to rectum using interrupted non-absorb-able sutures in one layer.
.Closed the abdomen without drainage.
Instruments required
.General set.
.Laparotomy set.
.Harrington splanchnic retractors
.Leyland-Jones clamps,1 pair
Any questions be sent to drmmkapur@gmail.com
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