Consent, give pre-op Ertapenem, and always mark patient in pre-op for possible ostomy.
When performing a laparoscopic partial colectomy, be able to independently and correctly determine the extent of mobilization.
The extent of colectomy should be based on the location of the neoplasm. A 5-cm margin is needed proximally and distally.
An extended right colectomy is needed for neoplasms at the hepatic flexure. This involves resecting the mesentery along both the ileocolic, right colic, and middle colic arcade.
For a malignant lesion in the left colon, resecting the mesentery of the inferior mesenteric artery territory is necessary for adequate resection.
When performing a laparoscopic partial colectomy, be able to secure and divide the blood supply to the portion of colon being resected.
The avascular area between the ileocolic and the right branch of the middle colic vessel should be followed when performing a right colectomy.
The vessels should be dissected appropriately and then divided with a laparoscopic energy device or double suture ligated after identification and preservation of duodenum on right and ureter on left.
The right colon to the splenic flexure is supplied by the ileocolic, right colic, and middle colic arteries. The left colon from the splenic flexure onward is supplied by inferior mesenteric artery and its branches.
Care should be taken when mobilizing the colon because dissection too far laterally puts the surgeon at higher risk of inadvertently mobilizing the kidneys or injuring the spleen.
Educational aid only. Verify every dose, indication, and guideline against current institutional protocol. This is not a substitute for clinical judgment.
