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Open Total Colectomy

David Berger, MD
Massachusetts General Hospital

Exposure

  1. Midline abdominal incision
  2. Entry to the Lesser Sac and Splenic/Hepatic Flexure Take Down

Mobilization of Descending and Sigmoid Colon

  1. Division of Mesenteric Vessels
  2. Mobilization of Volvulus
  3. Division of Distal Colonic Margin
  4. Division of Proximal Colonic Margin
  5. Removal of Specimen and Hemostasis

Colostomy

  1. Removal of Specimen and Hemostasis
  2. Mobilization to Allow for Stoma Maturation
  3. Identification of Stoma Site in LUQ
  4. Creation of Stoma

Closure

  1. Abdominal Fascia closed with #1 Running Prolene
  2. Skin closed with Staples
  3. Colostomy Maturation and Ostomy Bag Fixation