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Laparoscopic Low Anterior Resection

David Berger, MD
Massachusetts General Hospital

1. Exposure and Trocar Placement

  1. Infraumbilical Incision, Veress Needle Insertion, and Inflation
  2. Trocar Placement
 

2. Entry to Abdomen and Mobilization

  1. Port Placement
  2. Freeing Omentum from Abdominal Wall
  3. Descending Colon and Splenic Flexure Mobilization
  4. Sigmoid Colon Mobilization
  5. Isolation and Division of IMA Pedicle
 

3. Bowel Division

  1. Division of Lateral and Posterior Stalks
  2. First Bowel Division
  3. Isolation and Division of Marginal Artery
  4. Second Bowel Division
  5. Anvil Placement and Abdominal Closure
 

4. Colorectal Anastomosis

  1. Baker-Type Anastomosis
  2. Water-Immersion Sigmoidoscopy
 

5. Closure

  1. Subcuticular Suture