Platform QuadroPort+

Laparoscopic right hemicolectomy

Laparoscopic right hemicolectomy
D-r Puchkov D.K. (CMS) is performing an operation (2018).

A 61 year-old female patient was treated with diagnosis: Cancer of the hepatic flexure of the colon fT2N0M0, G2. During preoperation investigation of the abdominal cavity an extensive mass about 3.5 cm in diameter had been found out in the hepatic flexure of the colon according to the results of RCT. No lymph nodes were involved. The first stage: incision was done in paraumbilical area-3 cm. Platform QuadroPort+ (“Olympus”)was introduced into the abdominal cavity for performing one-port operation, CO2 gas was used for peritoneum. A 10 mm laparoscope, a 5 mm soft straight forceps and 5 mm curved forceps (“Medtronic Covidien”) and Harmonic scalpel device was introduced into the port. Firstly adhesion was separated. A. ileocolica was visualized, skeletonized and transected at the origin with 5 mm LigaSure (“Medtronic Covidien”) device. Then right part of the large colon was mobilized “downwards-to-upwards” within the boundaries of Toldt”s fascia with Harmonic Scalpel (“Ethicon”) device, descending part of duodenum and the head of pancreas were visualized. The peritoneum of the right lateral canal was transected, the gastrocolic ligament was resected up to the level of middle one-third of the transverse colon. Mesentery of the colon was mobilized up to the level of middle one-third of the transverse colic colon. Mesentery of the iliac colon was transected at the 10 cm proximally to Bauhin’s valve. The platform QuadroPort+ was removed from the abdominal cavity, resection of the right parts of the iliac and colon was done. Bistapler ileotransversoanastomosis “side-by-side” was formed. Anastomosis edges were additionally stitched by “Vicryl” 3-0 thread. The abdominal cavity was drained. Minilaparotomic wound was stitched layer by layer. Aceptic bandage was applied. Operation was about 145 minutes.