Laparoscopic-assisted segmental colectomy: Surgical techniques

T. D. Elftmann, Heidi Nelson, D. M. Ota, J. H. Pemberton, R. W. Beart

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: To describe our surgical techniques for successful completion of laparoscopic-assisted segmental colectomy. Design: We reviewed the important preoperative, operative, and postoperative factors that should be considered for laparoscopic resection of the right, left, and sigmoid colon. Results: The current indications for laparoscopic-assisted colectomy include most benign colonic conditions (such as colorectal polyps, rectal prolapse, diverticular disease, and colonic lipomas). Laparoscopic procedures for malignant disease, however, are currently reserved for prospective trials and palliation of patients with stage IV colonic cancer because the adequacy of staging and lymphatic resection remains questionable. Patients who are appropriate candidates for laparoscopic-assisted colectomy should be counseled about the potential benefits, risks, and possible need for conversion to an open surgical procedure - a decision that should be considered application of sound surgical judgment rather than a failure. For laparoscopic-assisted colectomy, we prefer to use the closed technique for establishing a pneumoperitoneum. We use a two-surgeon, four-cannula approach for resections of the right and left colon and a three-surgeon, five-cannula technique for resections of the sigmoid colon. Laparoscopic techniques are used to mobilize the bowel and divide the principal blood supply; the resection and anastomosis are performed extracorporeally, with use of a small incision. Conclusion: The associated morbidity and mortality rates are comparable to those for conventional open procedures. Despite a shortened period of ileus and fewer hospital days, the total costs for laparoscopic colectomy have been equivalent to those for standard colectomy. This result has generally been due to longer operative times, which should decrease with additional experience.

Original languageEnglish (US)
Pages (from-to)825-833
Number of pages9
JournalMayo Clinic Proceedings
Volume69
Issue number9
StatePublished - 1994

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Colectomy
Sigmoid Colon
Colonic Diseases
Rectal Prolapse
Conversion to Open Surgery
Pneumoperitoneum
Ileus
Lipoma
Operative Time
Polyps
Colonic Neoplasms
Colon
Morbidity
Costs and Cost Analysis
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Elftmann, T. D., Nelson, H., Ota, D. M., Pemberton, J. H., & Beart, R. W. (1994). Laparoscopic-assisted segmental colectomy: Surgical techniques. Mayo Clinic Proceedings, 69(9), 825-833.

Laparoscopic-assisted segmental colectomy : Surgical techniques. / Elftmann, T. D.; Nelson, Heidi; Ota, D. M.; Pemberton, J. H.; Beart, R. W.

In: Mayo Clinic Proceedings, Vol. 69, No. 9, 1994, p. 825-833.

Research output: Contribution to journalArticle

Elftmann, TD, Nelson, H, Ota, DM, Pemberton, JH & Beart, RW 1994, 'Laparoscopic-assisted segmental colectomy: Surgical techniques', Mayo Clinic Proceedings, vol. 69, no. 9, pp. 825-833.
Elftmann TD, Nelson H, Ota DM, Pemberton JH, Beart RW. Laparoscopic-assisted segmental colectomy: Surgical techniques. Mayo Clinic Proceedings. 1994;69(9):825-833.
Elftmann, T. D. ; Nelson, Heidi ; Ota, D. M. ; Pemberton, J. H. ; Beart, R. W. / Laparoscopic-assisted segmental colectomy : Surgical techniques. In: Mayo Clinic Proceedings. 1994 ; Vol. 69, No. 9. pp. 825-833.
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