Retracting the peritoneum laterally
With the patient rotated to the left in steep Trendelenburg position, the surgeon retracts the peritoneum laterally while the assistant retracts the right colon medially.
Trocar Placement
Placement of 10- to 12-mm trocars for laparoscopic assisted left colon resection. Two optional trocar sites (right upper quadrant and left lower quadrant) are occasionally helpful: , typical trocars; ¥, optional trocars.
anastomos is performed in an extracorporeal manner
Terminal ileum, cecum, ascending and proximal transverse colon eviscerated through the small midline incision. Resection and anastomosis will be performed in an extracorporeal manner. The anastomosis is then returned to the abdominal cavity.
Mobilization of right colon.
Mobilization of right colon. Two graspers pull the right colon medially as the white line of Toldt is incised.
Endoscopic view of hiatal hernia
The is the forward and reflexed view in a patient with severe GERD demonstrating a hiatal hernia