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  • 1. Introduction
  • 2. Access and Placement of Ports
  • 3. Colon Mobilization
  • 4. Conversion to Open Approach
  • 5. Proximal Bowel Division
  • 6. Extension of Incision
  • 7. Total Mesorectal Excision
  • 8. Division of Rectum
  • 9. Distal Side-to-End Anastomosis with EEA Stapler
  • 10. Test Anastomosis
  • 11. Closure
  • 12. Post-op Remarks
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Laparoscopic Low Anterior Resection with Diverting Loop Ileostomy for Rectal Cancer with Conversion to Open Approach

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Prabh R. Pannu, MD; David Berger, MD
Massachusetts General Hospital

Procedure Outline

  1. Free and Elevate Omentum
  2. Pull Transverse Colon Down and Enter Lesser Sac
  3. Descending Colon and Splenic Flexion Mobilization
  4. Clip and Divide Left Colic Artery
  5. Finish Proximal Mobilization
  6. Sigmoid Colon and Rectum Mobilization
  7. Isolation and Division of IMA Pedicle
  8. Continue Distal Mobilization
  1. Marginal Artery Division
  1. Check Tumor Location with Colonoscope
  1. Prepare Loop Ileostomy Exit Site
  2. Close Abdomen
  3. Staple Port Incisions
  4. Inject Local Anesthetic
  5. Staple Midline Laparotomy Incision
  6. Mature Loop Ileostomy