Laparoscopisc resection of the sigmoid
The diagnosis of the tumor was made by means of x-ray and colonoscopy with biopsies.
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Under general anesthesia the abdomen is insufflated with CO2 gas. A camera is introduced and inspection af het abdominal cavity takes place (1). A couple of other working channels are introduced through which instruments can be used (2).
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The tumor is clearly visible (3). The vesselcontaining part of the gut is freed from the large vessels that suply the leg (4). Freeing of the vessels that come from the aorta to the gut (5, blue cirkel) and cutting of them between clips (6).
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Subsequently freeing of the gut from the lateral abdominal wall (7) and cutting the gut right above the lower part that goes in the small pelvis. A special device is used that closes the gut at two sides and cuts it in between (8,9).
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Now the gut is sufficiently freed to remove the sick part through a small transverse incision right above the pubic bone (10, 11). Now another special device is used. One part is introduced in the upper part of the gut (14,13,14) and fixed with a suture. It is then put back in the abdomen. The wound is closed and again gas is insufflated and the laparoscopy is resumed.
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With a clamp the device is catched and hold. Now the other part of the special device is introduced through the anus to the lower part of the gut (orange part) and a connection is made between the two parts.
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The device is closed, bringing the two parts of the gut together (18) and then the device is fired, making a connection with staples between the gut and cutting the gut within the borders of the just made connection (19,20). Thus a ring of gut is cut, freeing the device so that it can be removed.
Because of the small wounds with this kind of operation, recovery will be sooner and less painfull, compared to the classical operation where a large incision is necessary. Furthermore, there are cosmetical advantages as shown in the picture below, over a year after surgery.
