SILS right hemicolectomy

Abstract

1. Insert SILS port at the umbilicus (supine) 2. Expose the mesentery of right and transverse colon (bare area) (right side elevated, slight Trendelenburg) Position omentum over transverse colon Deliver SB to the left of the midline Expose Duodenum 3. Identify, isolate the ileocolic pedicle, and divide it (right side elevated, slight Trendelenburg) 4. Open a peritoneal window above and below the pedicle (right side elevated, reverse Trendelenburg) 5. Develop the retroperitoneal plane (right side elevated, slight Trendelenburg) 6. Expose and divide R branch of middle colic (Right side elevated, steep Trendelenburg) 7. Retroperitoneal takedown of the hepatic flexure (right side elevated, steep Trendelenburg) 8. Enter the lesser sac (right side elevated, steep Trendelenburg) 9. Release the ileocolic attachments (inferior to superior), enter previous retroperitoneal dissection plane (right side elevated, steep Trendelenburg) 10. Takedown the right lateral sidewall (right side elevated, moderate Trendelenburg) 11. Divide the terminal ileum and exteriorize the right colon (supine) 12. Extracorporeal division of the colon and ileocolic anastomosis (supine) 13. Return the colon to abdomen, reinsufflation, and final examination (supine) 14. Close ports/incisions (supine).