OPERATION: Laparotomy, Left Hemicolectomy and End Colostomy
ANAESTHETIC: General anaesthesia
ANTIBIOTICS: Gentamicin and Metronidazole
POSITION: Lloyd-Davis. VTE prophylaxis. Urinary catheter.
FINDINGS: [Obstructing tumour or stricture of descending or sigmoid colon].
PROCEDURE:
Midline laparotomy. Alexis wound protector.
Lateral mobilisation of sigmoid and descending colon.
Adhesions divided. Window in mesentery at rectosigmoid.
Rectum divided with contour stapler.
Colon mesentery divided with Ligasure.
Lesser sac entered. Splenic flexure fully mobilised.
Colon divided at appropriate level with GIA stapler.
Trephine at premarked left iliac fossa site.
Colon delivered without twist.
2x looped PDS to sheath. Collatamp applied. Clips to skin.
End colostomy matured with 3-0 Monocryl.
POST-OPERATIVE INSTRUCTIONS:
Free fluids orally. Trial without catheter when mobile.
Clip removal at 14 days. 28 days Dalteparin prophylaxis.
Follow-up pending histology.