• 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.
     
Right Sigmoid Colectomy Port Placement
  • 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.
       
Sigmoid colectomy room setup
  • Surgeon is on patient’s right side.
  • Monitor is opposite from the surgeon.
  • Assistant is next to the surgeon.
  • Recording device is available.