OPERATION: Laparoscopic Panproctocolectomy and End Ileostomy
ANAESTHETIC: General anaesthesia
ANTIBIOTICS: Gentamicin and Metronidazole
POSITION: Right lateral then Lloyd-Davis.
FINDINGS: [Inflammatory bowel disease / familial polyposis / synchronous colorectal pathology].
PROCEDURE:
10mm Visiport at umbilicus in right lateral position. 3x 5mm ports.
Left colon mobilised with diathermy and Ligasure to midline.
Greater omentum separated from transverse colon. Splenic flexure mobilised.
Repositioned to Lloyd-Davis. 3x 5mm and 2x 10mm ports.
Right colon mobilised off duodenum and head of pancreas.
Ileocolic, right colic arteries and veins divided with Ligasure.
Transverse colonic mesentery divided. Middle colic vessels clipped and divided.
Terminal ileum divided with EndoGIA.
IMA taken. Left ureter identified and preserved.
TME dissection to pelvic floor.
Perineal dissection. Conservative elliptical incision. Specimen delivered.
Ileostomy fashioned at premarked right lower quadrant site with 3-0 Monocryl.
Perineum closed: 1 Vicryl to pelvic floor. Vicryl continuous to skin.
POST-OPERATIVE INSTRUCTIONS:
Enhanced recovery protocol. Eat and drink as able.