Laparoscopic Low Anterior Resection step by step for low rectal cancer

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Surgeon(s)/Speaker(s): Dr Vipin Goel

Surgical Procedure: Colorectal-Anterior Resection

Location:

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Indexsteps

1. 1st position - Lloyd Davies low lithotomy position : Lloyd Davies low lithotomy position - max head low

2. Exposure of IMA root : Exposure of IMA root

3. Small bowels retracted out of the field : Small bowels retracted out of the field

4. TME started : TME started

5. Nerve exposed : Nerve exposed

6. Right lateral dissection done : Right lateral dissection done

7. IMA taken : IMA taken

8. Left ureter demonstrated : Left ureter demonstrated

9. Dissection along Toldt's line : Dissection along Toldt's line

10. Left mobilization done : Left mobilization done

11. Distal margins stapled : Distal margins stapled

12. Access incision taken : Access incision taken. Using wound protector specimen excised

13. Purse string taken and anvil placed : Purse string taken and anvil placed

14. Incision closed : Incision closed

15. End to end anastomoses with stapler : End to end anastomoses with EEA stapler

16. Leak test : Leak test

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port positions

1. Port position for Lap AR : 4 ports

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Surgical Instruments

1. 12 mm Trocar

2. 5 mm Trocar

3. Fundus Grasper with Ratchet

4. Harmonic Scalpel

5. Stapler

6. 30 degree 10mm telescope

7. Gas insufflation equipment

8. Bowel Grasper

9. Ultrasonic Shear

10. Suction Irrigation canula

11. Medium wound protector

12. Foley catheter