Laparoscopic Sigmoid Colectomy by Nezar Jrebi, MD and Jay Redan, MD
Authored by
Nezar Jrebi, MD and Jay Redan, MD
Authored by
Nezar Jrebi, MD and Jay Redan, MD
Laparoscopic Sigmoid Colectomy by Nezar Jrebi, MD and Jay Redan, MD
Prep & Patient Positioning
Prep & Patient Positioning
- Typically, the patient is placed in the lithotomy position, with Allen stirrups.
- Arms tucked.
- IMPORTANT: Patient secured to the table.
- OG (oral-gastric) tube.
- Foley catheter, possible urethral catheters.
- The surgeon is usually on the patient’s right side with the assistant.
- Sometimes surgeon will go between the legs for the splenic flexure part of the operation to maintain good ergonomics.

- Generally, 3-4 ports are used: two to three 5 mm and one 12 mm. Common variations:
- One 5 mm port in the right upper and one in the right lower quadrant and one 12 mm periumbilical port.
- One 5 mm port in the right upper quadrant, one 12 mm port in the right lower quadrant and one 5 mm periumbilical port.
- One 5 mm port in the right upper quadrant, one 5 mm port in the right lower quadrant, one 5 mm port in the left upper quadrant and one 12 mm periumbilical port.
- One 5 mm port in the right upper quadrant, one 12 mm port in the right lower quadrant, one 5 mm port in the left upper quadrant and one 5 mm periumbilical port.
NOTE: Must know tumor location prior to starting the case for proper trocar placement.
- Following factors/decisions will affect trocar placement.
- Decide if vascular pedicles are stapled or energy is used.
- Decide intracorporeal or extracorporeal anastomosis.
- Colon extraction site.


- Surgeon is on patient’s right side.
- Monitor is opposite from the surgeon.
- Assistant is next to the surgeon.
- Recording device is available.
