.

l32

Surgicol Procedures lncluding Minimol Access Piocedures

'
Srh Preporotion:,

Goslrolntesllnolsursery

133

SpeciolNotes
The scrub person may receive specimen in a basin. ' Instruments used on the colon are isolated in a basin. "Clean" closure of the abdomen requires regowning, regloving, and redraping and a Basic/lVlinor procedures

Begin at the incision (midliire or transverse) extending from nipples to upper thighs, and down to the table at

fu

sides.

tray.
TRANSVERSE COTECTOMY

iloping frlded towels '

GqJprnent

and..a transverse or laparotomy sheet (depending on incision)

Definition
Resection of a segment of the transverse-colon with an

flectlosurgical unit

end-to-end anastomosis to reestablish continuity ofthe

colon.
DiSCUSSION

Transverse colectomy is usually performed 4s treatment for a malignancy or a stricture caused by inflammatory bowel disease. Procedure

procedures tray intestinal procedures tray ic stapling device (optional) ip appliers (various sizes)

retractor ining retractor (e.g., Balfour)

A vertical or transvetse incision may be used. The

transverse colon and hepatic and splenic flexures are mobilized by dividing vascular mesenteric attachments and suppoiting connective tissues. The appropriate segment of colon is excised between clamps (atraumatic clamps may be used on the portions of the retained bowel), or an automatic stapling device may be employed. An anastomosis is fashioned between the proximal and distal colon, and the mesenteric defect closed; sufficient mobility must be achieved to enable the anastomosis to be tension free. Injury to the stomach, pancreas, spleen, and superior mesenteric vessels is avoided. The wound is closed in layers.

set (3) No. 10

tubing
pencil (various sizes) magnet or counter (optional) Notes ts used on the colon are isolated in a basin. can be received in a basitr. of the bowel may be covered with lap pads or gloves and tied with umbilical tape to prevent ation of the abdomen. Tlean" closure of'the abdomen requires regowning, gfuving, and redraping and a Basic/lVlinor procedures

Preporotion of the Potient The patient is supine; arms may be extended on armboards, Check with surgeon regarding insertion of a Foley catheter before beginning preparation. Apply
electrosurgical dispersive pad.