Laparoscopic Left Colectomy

Technique Description:

• 1. Female
• 2. 57 years old
• 3. BMI 28.3
• 4. ASA II
• 5. Hypertension history with pharmacological treatment
• 6. Previous Caesarean section

Procedure Steps:

• 1. Colo-epiploic detachment
• 2. IMA and IMV section at origin
• 3. Splenic flexure mobilization
• 4. Preparation of rectal stump and its section
• 5. Knight-Griffen anastomosis
• 6. Air Blu Test

Learning Points:

• Hybrid splenic flexure mobilization
• Nerve sparing near the origin of IMA
• Good blood supply of the rectal stump after preparation
• Prevention of leakage with testing the anastomosis with air blu test

Clinical History:

• Female
• 57 years old
• BMI 28.3
• ASA II
• Hypertension history with pharmacological treatment
• Previous Caesarean section
• Pain in the lower parts of the abdomen
• Irregular alvus
• FOBT ++
• Colonscopy: 50 cm from a.v. presence of stenotic and bleeding lesion… biopsies identify fragments of adenocarcinoma