Francisco Benavides, MD, Thushy Siva, MD, Avian Chang, MD, Savni Satoskar, MD, Joshua Ziehm, DO, Vinay Bajaj, MD, Anthony Dippolito, MD, MBA, FACS. Easton Hospital
In this video we demonstrate a technique for performing an intracorporeal anastomosis during a laparoscopic right hemicolectomy for a cecal adenocarcinoma. The patient is placed in a supine position and four ports are placed: A 15-mm port at the umbilicus using open Hasson technique, a 12-mm right upper quadrant port, a 12-mm left lower quadrant port, and a 5-mm left upper quadrant port. After proper dissection and mobilization of the cecum, ascending colon, hepatic flexure, and transverse colon, the terminal ileum and proximal transverse colon are each transected using an endoscopic stapler and the specimen is placed above the liver for retrieval and extraction later. The proximal and distal anastomotic bowel segments are then placed in close proximity to the right upper quadrant port. Suspending sutures are placed through the anterior abdominal wall and through the staple line of the ileum and transverse colon and then back out through the abdominal wall. The suture loops are secured externally using a hemostat. Next, enterotomies are made over the staple line of the ileum and transverse colon. An endostapler is passed through the right upper quadrant port site and a side to side anastomosis is constructed while the bowel is stabilized using the suspensory sutures. A second load is used to ensure sufficient anastomotic length. The stapler is reloaded and passed through the left lower quadrant port and fired transversely to complete the anastomosis. The resected bowel is then placed in an endoscopic retrieval bag along with the anastomotic fragments and removed from the umbilical port site.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94712
Program Number: V247
Presentation Session: Video Loop Day 2
Presentation Type: VideoLoop