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- Open
- Careful handling of colon
- No rectal resection
- 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
