Laparoscopic Right Hemicolectomy
Preoperatively, patients undergo an appropriate medical evaluation. Imaging studies including CT scan, barium studies, and colonoscopy are undertaken for preoperative planning to assess the location of disease, review any associated complications, and identify any synchronous lesions. Preoperative marking of polyps by endoscopic tattooing using India ink is necessary to ensure intraoperative identification of the lesion and to avoid the need for intraoperative colonoscopy. In patients with recurrent Crohn’s disease or history of multiple laparotmoies, imaging studies are particularly important in providing “roadmaps” to define extent of previous resections, length of remaining bowel, and degree of previous mobilization of flexures. Preoperative mechanical and antibiotic bowel preparation consists of 45 cc sodium phosphate solution (Fleets phosphosoda; C.B. Fleet Co., Inc., Lynchburg, VA) PO at 4 pm and at 9 pm, each followed by 3–8 oz glasses of water, and 1 gm neomycin with 500 mg metronidazole at 7∶00 and 11∶00 pm.
KeywordsMesenteric Defect Cecal Volvulus Ileocolic Anastomosis Sodium Phosphate Solution Middle Colic Vessel
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- Cera C, Wexner SD. Diverticulitis. In Advanced Therapy of Minimally Invasive Surgery. New York, B.C., Decker (in press).Google Scholar
- Wexner SD Guest, Ed) Laparoscopy for benign disease. Seminars in Laparoscopic Surgery. New York, Westminster Publications 2003.Google Scholar
- Wexner SD (Guest, Ed). Laparoscopy for malignant disease. Seminars in Laparoscopic Surgery. New York, Westminster Publications 2004.Google Scholar