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Three trocar sigmoidectomy for diverticulitis with transanal extraction
The combination of laparoscopy and specimen extraction through a natural orifice has the potential to decrease wound complications and to improve postoperative recovery.
The objective of this film is to demonstrate the possibilities of specimen extraction of a sigmoid diverticulitis transanally with reduction of abdominal openings that may sometimes induce incisional hernias and postoperative pain.
In this case, a laparoscopic three-port technique is performed: one 12mm optical port situated in the umbilicus, and two right iliac fossa ports (one 5mm port placed in the right flank, and a 12mm port in the right iliac fossa for introduction of staplers).
J Leroy, J Marescaux
Surgical intervention
10 years ago
261 views
23 likes
0 comments
09:26
Three trocar sigmoidectomy for diverticulitis with transanal extraction
The combination of laparoscopy and specimen extraction through a natural orifice has the potential to decrease wound complications and to improve postoperative recovery.
The objective of this film is to demonstrate the possibilities of specimen extraction of a sigmoid diverticulitis transanally with reduction of abdominal openings that may sometimes induce incisional hernias and postoperative pain.
In this case, a laparoscopic three-port technique is performed: one 12mm optical port situated in the umbilicus, and two right iliac fossa ports (one 5mm port placed in the right flank, and a 12mm port in the right iliac fossa for introduction of staplers).
Laparoscopic sigmoidectomy for sigmoid diverticulitis in an obese (BMI=39) female patient
This video demonstrates the laparoscopic approach to sigmoid resection following previous attacks of diverticulitis. The medial vascular approach is employed, although in this case the inferior mesenteric artery is preserved. Obesity presents particular problems of reduced space and difficulty in identification of structures because of visceral adiposity. This video is suitable for advanced laparoscopic digestive surgeons.

The authors use the medial vascular approach, preserving the inferior mesenteric artery. The obese patient presents the dual challenge of reduced space and difficulty in identifying structures. The authors gain exposure of the mesosigmoid, and initially incise the peritoneum to divide the vessels, respecting the superior rectal vessels. They divide only the sigmoid vessels to preserve the superior rectal artery and vein.
J Leroy, J Marescaux
Surgical intervention
12 years ago
1339 views
10 likes
0 comments
21:15
Laparoscopic sigmoidectomy for sigmoid diverticulitis in an obese (BMI=39) female patient
This video demonstrates the laparoscopic approach to sigmoid resection following previous attacks of diverticulitis. The medial vascular approach is employed, although in this case the inferior mesenteric artery is preserved. Obesity presents particular problems of reduced space and difficulty in identification of structures because of visceral adiposity. This video is suitable for advanced laparoscopic digestive surgeons.

The authors use the medial vascular approach, preserving the inferior mesenteric artery. The obese patient presents the dual challenge of reduced space and difficulty in identifying structures. The authors gain exposure of the mesosigmoid, and initially incise the peritoneum to divide the vessels, respecting the superior rectal vessels. They divide only the sigmoid vessels to preserve the superior rectal artery and vein.
Laparoscopic sigmoidectomy for sigmoid diverticulitis in an obese (BMI=30) male patient
This is a didactic video demonstrating laparoscopic sigmoidectomy for diverticular disease. A combined medial and lateral approach is employed in the dissection of the sigmoid vessels, preserving the IMA. The use of the LigaSure device greatly facilitates the dissection. This approach is suitable for general and digestive surgeons.

The authors use a medial approach to divide the branches of the sigmoid vessels. In performing the medial resection for cancer, the authors caution to avoid contact with the colon. The approach may involve a combination of medial and lateral techniques. Monopolar shears help carry out the dissection using traction. Freeing the vessels laterally enables visualization of the mesocolon.
J Leroy
Surgical intervention
12 years ago
1012 views
23 likes
0 comments
17:22
Laparoscopic sigmoidectomy for sigmoid diverticulitis in an obese (BMI=30) male patient
This is a didactic video demonstrating laparoscopic sigmoidectomy for diverticular disease. A combined medial and lateral approach is employed in the dissection of the sigmoid vessels, preserving the IMA. The use of the LigaSure device greatly facilitates the dissection. This approach is suitable for general and digestive surgeons.

The authors use a medial approach to divide the branches of the sigmoid vessels. In performing the medial resection for cancer, the authors caution to avoid contact with the colon. The approach may involve a combination of medial and lateral techniques. Monopolar shears help carry out the dissection using traction. Freeing the vessels laterally enables visualization of the mesocolon.