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The Operation Primer "Laparoscopic Sigmoidectomy for Diverticulitis" gives a detailed overview of the patients' preparation, surgical key steps, and pitfalls of laparoscopic sigmoidectomy for diverticulitis. The major goal was to provide a comprehensive surgical guide book for laparoscopic colorectal surgeons helping to avoid those pitfalls leading to complications.
List of contents
Introduction Structure and handling of the Operation Primer I Preparations for the operation Instruments Emptying the bladder Positioning of the patient Shaving Neutral electrode Setting the equipment Skin disinfection Sterile draping Positioning of the operating team II Creating the pneumoperitoneum - placing the optical trocar a) Hasson Method (open technique) b) Trocar with obtical obturator c) Veress needle (closed technique) III Placing the working trocars Placing the working trocars IV Nodal points 1. Exploring the abdominal cavity 2. Identifying the anatomical landmarks 3. Mobilizing the left lateral colon 4. Mobilizing the splenic flexure 5. Dissecting the sigmoid mesentery 6. Dissecting the upper mesorectum 7. Dividing the upper rectum 8. Extracting the sigmoid 9. Dividing the proximal colon and preparing the anastomosis extraabdominally 10. Preparing the anastomosis intraabdominally 11. Anastomosing the colon 12. Verifying the anastomosis 13. Finishing the operation V Management of difficult situations, complications and mistakes 1. Adhesions 2. Blood vessel injuries a) Diffuse bleeding / bleeding from minor vessels b) Bleeding from major vessels 3. Organ injuries a) Greater omentum b) Bowel c) Spleen d) Stomach e) Liver 4. Preperitoneal air emphysema a) Veress needle b) Trocar 5. Losing a swab in the abdominal cavity 6. Adhesion of the sigmoid to the abdominal wall 7. Injury of the left ureter 8. Injury of iliac vessel 9. Difficulties when clipping a) Incorrectly positioned clips b) Unsafelypositioned clips c) Lost and slipped clips 10. Positive anastomotic leak test 11. Rotation ot the left colon VI Anatomical variations Sigmoid position variations Appendix Sample operation note Bibliography Liste of key words
About the author
Prof. Dr. med. Hans-Peter Bruch, ab 1982 Oberarzt der Chirurgischen Universitätsklinik Würzburg im Rahmen der Hand-, Unfall-, Gefäß- und Allgemeinchirurgie, ab 1985 Leiter der Chirurgischen Universitäts-Poliklinik Würzburg§1986 Ernennung zum Professor für Chirurgie§Seit 1990 Direktor der Klinik für Chirurgie des Universitätsklinikums Schleswig-Holstein, Campus Lübeck§Seit 1992 Mitglied des Executive Board of the European Council of Coloproctology§Mitglied in zahlreichen Chirurgenvereinigungen des In- und Auslandes, Mitglied des Editorial Board diverser deutsch- und englischsprachiger Zeitschriften§Seit 1999 Mitglied der Leopoldina§Seit 2004 Sekretär der Deutschen Gesellschaft für Viszeralchirurgie
Summary
The Operation Primer “Laparoscopic Sigmoidectomy for Diverticulitis” gives a detailed overview of the patients’ preparation, surgical key steps, and pitfalls of laparoscopic sigmoidectomy for diverticulitis. The major goal was to provide a comprehensive surgical guide book for laparoscopic colorectal surgeons helping to avoid those pitfalls leading to complications.
