Resection of small colon

Laparoscopic approach in the treatment of retrocervical endometriosis with the affected iliac colon

Laparoscopic approach in the treatment of retrocervical endometriosis with the affected iliac colon.
Professor Puchkov K.V. is performing an operation (2016).

A 34 year-old patient was operated for deep infiltrating retrocervical endometriosis and affected iliac colon. In her anamnesis it is mentioned that she has had two cesarean sections. During laparoscopy it had been found out that the patient has a massive adhesions of organs of small pelvis with the involvement of greater omentum, sigmoid colon, uterus and the urinary bladder. In this video the technique of adhesion dissection by a 5 mm monopolar electrode and a 5 mm LigaSure («MEDTRONIC COVIDIEN») instrument is presented. During revision the lesion of the iliac colon by the invasive endometriosis at the distance of 4 cm from the ileocecal angle had been found out. The length of lesion was 6 cm. The focus invaded to all layers of the intestinal wall, and stenosis of organ lumen had been formed. Trocar port was expanded up to 4 cm, and an affected area of the colon was exteriorized onto the abdominal wall. Resection of some area of small colon was done with the dissection of the mesentery near the wall of colon, preserving the branches of a.ileocolica. It has given a possibility to form “end-to-end” anastomosis near the large colon, placing an atraumatic suture, using manual stitching and “Polysorb” thread 4-0. Suture line was additionally strengthened by a hemostatic patch TachoComb (Austria). Anastomosis was immersed into the abdominal cavity. Operation duration was 120 minutes.

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.