Editing Subtotal colectomy

== Pre-op: ==

* Ileostomy marked

== Principles: ==

* Open
* Careful handling of colon
* No rectal resection

== Technique ==

* Generous laparotomy
* Diagnostic laparotomy,     including purse-string closure of perforations and lavage
* Mobilise colon from lateral     attachments, starting at the caecum and mobilising it round completely to     the rectum
** Dissect omentum from      transverse mesocolon, aiming to preserve it
* Divide the vessels
** Trans-illuminate the colon      and divide them close to bowel, at a suitable place
** Preserve terminal ileal      arcades
* Mobilise TI and divide it     with a stapler 1-2cm proximal to ICV
* Divide lower sigmoid colon     and hand off specimen
** If too friable to be      stapled, bring it out to fascia as a mucus fistula
* Final wash and close abdomen
* Form ileostomy

[[Category:Colorectal]]