Primary port put in by open Hasson technique using blunt Hasson port.
Secondary ports put in with direct visualisation.
Five ports were used: one 12mm port in the umbilicus, and four 5mm ports in the left lower quadrant, right lower quadrant, left mid-clavicular line and right mid-clavicular line.
The colon was mobilized and the rectum was identified.
The mesorectum was divided with the ultrasonic scalpel and the rectum was transected with a linear stapler.
The specimen was removed and the remaining rectal stump was oversewn with a linear stapler.
The ports were removed under direct vision.
A perineal phase of the procedure was performed with a transanal approach using a circular stapler to excise the rectum and the anus.
A permanent end colostomy was created.
Suction irrigation was carried out.
Haemostasis was ensured.
No.1 PDS box stitch to fascia for primary port site.
3.0 monocryl subcuticular sutures.
Interrupted sutures to skin.
POST OPERATIVE INSTRUCTIONS:
Post op bloods tomorrow (ddmmyy)
Diet: Eat and Drink as tolerated
LMWH at 18:00 hours