Three-trocar laparoscopic sigmoidectomy with transanal extraction for diverticulitis and endometriosis

This video demonstrates an uncomplicated laparoscopic right hemicolectomy in an obese lady with cecal cancer. The surgeon uses 4 trocars to achieve medial mobilization of the mesentery, divide the ileocolic at the root and then mobilize the right colon up to proximal transverse colon. The terminal ileum is divided intracorporeally and the specimen is retrieved through a right lateral skin crease muscle splitting incision. An extracorporeal stapled anastamosis is made and the mesenteric window is not closed.
This video is a good demonstration of key anatomic landmarks, surgical planes, and surgical approach to a right hemicolectomy for cancer using the medial approach.

Diverticulosis of the left colon is an inflammatory benign disease associated with unpleasant morbidity which lead to pneumaturia and repetitive urinary infection. Computed tomography and colonoscopy may suggest the diagnosis but histology confirms it. The differential diagnosis evokes a malignant lesion and so it is mandatory to perform surgery with an oncological plane. This clinical case is that of a young man with a mass, which includes the left colon, the bladder, and the ileocaecal appendix. A ureteral stent was placed to make surgery safer and a sigmoidectomy with an ileocaecal appendectomy is performed.

The author presents his left colectomy technique for diffuse diverticulosis of the left colon. He uses an oncological dissection technique with a vascular approach starting with the vein and then moving on to the inferior mesenteric artery. He continues the technique with the mobilization of the splenic flexure with a posterior medial approach which is followed by a mobilization of the sigmoid and the colorectal junction, and finally by a colorectal anastomosis.

This live surgical video demonstrates in detail laparoscopic sigmoidectomy by Dr. Joel Leroy. A medial approach to the sigmoid mesocolon is used, combined with lateral dissection for a complete mobilization of the splenic flexure. This procedure is recommended to surgeons with an interest in laparoscopic colorectal surgery.

Colonic diverticulosis is an increasingly common condition in Western societies. Sigmoid colectomy for diverticulitis can be technically challenging because of severe inflammation in the left lower quadrant and pelvis.
We here present a standard elective sigmoidectomy, after episodes of diverticulitis treated medically.

Dr. P Sylla, MD (Massachusetts General Hospital, Boston, USA) provides a running comment on a laparoscopic sigmoidectomy for cancer performed by Dr. A Melani, MD, Scientific Director of IRCAD America Latina training centers in Barretos and Rio de Janeiro (Brazil). Dr. P Sylla provides an authoritative analysis of this colorectal procedure, with a large amount of tips and tricks.

The objective of this film is to demonstrate a completely laparoscopic technique for left colon resection and for cancer of the descending portion of the splenic flexure.

In this lecture, Prof. Corcione uses his experience in left laparoscopic colectomy to present some tips and tricks.

This is a live video demonstration of a totally laparoscopic approach to right colectomy. The surgeon stands on the left side and performs a medial vascular approach including medial mobilization of the right colon and hepatic flexure. The specimen is resected and extracted before pneumoperitoneum is re-created for an intracorporeal ileo-colic stapled anastomosis. This technique is suitable for advanced laparoscopic surgeons.