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Total Abdominal Colectomy: Straight Laparoscopic Approach

  • Amanda V. Hayman
  • Eric J. DozoisEmail author
Chapter

Abstract

Straight laparoscopic total abdominal colectomy (TAC) can be performed electively for indications such as slow transit constipation and hereditary polyposis syndromes, as well as in urgent situations for inflammatory and infectious conditions, most commonly ulcerative colitis. In the latter cases, an end ileostomy, as opposed to an ileorectal anastomosis, is usually performed, reserving reconstruction for a later date. Perceived benefits include fewer intra-abdominal adhesions, incisional hernias, and wound infections, as well as improved cosmesis—albeit with longer operative times than hand-assisted or traditional open approaches. Numerous extraction sites can be used, including the ileostomy site or natural orifices, obviating an additional transabdominal incision. Despite being technically difficult with the attendant risks of laparoscopic colon surgery, straight laparoscopic TAC can be performed safely with significant potential benefit to the patient.

Keywords

Lynch Syndrome Splenic Flexure Mechanical Bowel Preparation Ileorectal Anastomosis Rectal Stump 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 8.1

The abdominal portion of a total proctocolectomy in a patient undergoing a straight laparoscopic approach (Video by Sang Lee, MD) (MP4 153,660 kb)

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Division of Colon & Rectal Surgery, Department of SurgeryMayo ClinicRochesterUSA

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