Laparoscopic Sigmoid Colectomy Procedure, Steps, Port Placement

Laparoscopic Sigmoid Colectomy is a surgery performed to treat or avoid diseases that occur in the intestinal colon. This surgery previously served as an open Colectomy. With the advancement of technology, doctors and surgeons prefer Laparoscopic Colectomy, which takes less time to heal and is not as painful as open Colectomy. This surgery is done with the help of a tiny camera inserted through the incision made in the abdomen’s wall. It is also a relatively cheaper option, and the time of the operation is even less.

What is Laparoscopic Sigmoid Colectomy

Laparoscopic Sigmoid Colectomy, which is also known as Laparoscopic Colectomy or minimally invasive Colectomy, is a surgery performed to treat and avoid diseases like severe bleeding in the intestinal colon that cannot be controlled which may or may not require surgery to remove the part of the colon that is affected or damaged in any way.

Another condition that demands this operation is Bowel obstruction, a blocked colon; this needs to be treated through total or partial Colectomy; this depends on the severity of the situation. Colon cancer is also a hazardous disease in which Colectomy is needed. In early-stage cancers, only a part of the colon is removed. According to what doctors may recommend, they may withdraw more at later stages, which is also a Preventive surgery if someone has a high risk of colon cancer because of the development of multiple precancerous colon polyps. He/she may have to go through a total Colectomy to prevent cancer in the future.

Laparoscopic Sigmoid Colectomy Procedure, Steps, Port Placement

Laparoscopic Sigmoid Colectomy procedure

Laparoscopic Sigmoid Colectomy surgery’s specific details depend entirely on the facts and severity of the patient’s case. The surgeon gives detailed instructions to the patient to prepare him/her for the surgery. The patient may be required to drink a special liquid to empty your bowel before surgery and take antibiotic pills to prevent infection. Routine blood investigations, chest x-ray, and ECG(Electrocardiogram) are performed.

Tomography Scans of the chest, abdomen, and pelvis are also included in the preoperative preparation. Colonoscopy and Biopsy of the abrasion are done to confirm the diagnosis further. It is also preferable to prepare two units of packed red blood cells. Drugs for mechanical bowel preparation are usually given as early as possible on the day before the surgery to avoid gaseous swelling of the intestinal colon, creating technical difficulties during the operative procedure.

Steps of Laparoscopic Sigmoid Colectomy

First of all, the patient is given a dose of Anesthesia and then positioned in the lithotomy position with both hands tucked and the thighs placed at a 10-degree angle to the torso. A bean bag or a similar bed is used to secure the patient in position on the operating table, and a lot of attention is given to the pressure points. Then the abdomen and perineum are prepared with a sterilizing solution.

The primary surgeon stands on the patient’s right side, and the surgeon’s assistant stands on the patient’s left side. The surgeon observes the video on a screen in the operating room as he/she uses the tools to free the colon from the surrounding tissue. The colon is then brought out through a small incision in the patient’s abdomen. This lets the surgeon operate on the colon outside of the patient’s body. Once the surgeon repairs or mends the colon, he/she inserts it back through the incision from where it was taken out.

This kind of Colectomy reduces the pain and recovery time after the surgery. Once the colon has been repaired or removed, the surgeon will reconnect the patient’s digestive system to allow his/her body to expel waste. This may include rejoining the remaining portions of the patient’s colon or connecting their intestine to an opening in their abdomen.

Laparoscopic Sigmoid Colectomy Port Placement

This port is placed at a precise location on the abdomen. First of all, a vertical midline incision is marked as the site of the hand port insertion. This incision of six to seven centimeters outlines the umbilicus, and it is deepened through the linea alba and peritoneum to the abdominal cavity. Hemostasis is secured with diathermy. Two stitches are placed and attached to the hemostatic clips to allow the abdominal wall’s lifting during the hand port’s insertion and later to facilitate the surgeon’s non-dominant hand’s frequent introduction.

Care is taken not to touch the hand port with the clips. The hand port is injected by moving the flexible ring slowly forward into the abdominal opening after lifting the abdominal wall using the stay stitches on that particular side. The other stay seam is then raised, and the malleable ring is slowly and gently pushed into the abdominal cavity. Full airtight contact between the flexible ring of the disc and the frontal abdominal wall is secured. The lap disc aperture is tightened clockwise around a ten to eleven-millimeter trocar, and pneumoperitoneum is induced by insufflating the abdomen with CO2 to 13-15 mmHg.

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