At mean follow up of 36 months global cancer related survival is 85%.Ĭonclusion: With the technique shown a complete laparoscopic take down of the splenic flexure is performed, allowing a tension free anastomosis and the retrievement of an oncologically adequate specimen through a low minilaparotomy. Thirteen (5.6%) symptomatic leaks occurred in left colectomies and 19 (10.5%) in anterior resections. The proximal segment, the cecum and the ascending and. Mean operative time was 228±58 minutes for left colectomies and 284☗8 minutes for low anterior resections number of lymphnodes retrieved was 13☗, length of specimen 27☑4 cm. The splenic flexure marks an intermediate position in the colon both anatomically and physiologically. Results: Out of 579 laparoscopic elective colorectal resections for cancer, 234 were for left colon cancers and 181 for rectal cancers.
The inferior mesenteric vein is divided the mesentery of the left colon is detached from the Gerota a hole is made in the mesentery of the transverse colon above the pancreas allowing the gas to enter the lesser sac the mesentery of the flexure is detached from the pancreas in a mediolateral direction the colon is detached from the omentum and the left abdominal gutter and the flexure mobilised. Methods: The patient is in Trendelemburg position, rotated to the right. of the transverse colon, splenic flexure, descending colon, and sigmoid.
It allows a tension-free anastomosis and a proper exteriorisation of the specimen with the ligated origins of the inferior mesenteric vessels through a minilaparotomy located in the lower abdomen. The right colon consists of the cecum, ascending colon, hepatic flexure and the. Introduction: Take down of the splenic flexure is a crucial part of laparoscopic anterior resection.