Creation of Sigmoid Pouch

The lateral attachments of the sigmoid colon are dissected free to allow for limited manipulation. The amount of dissection required for the cystectomy portion of the procedure usually allows enough mobility. The sigmoid colon is then incised along its antimesenteric borders using a monopolar hook electrocautery. Individual anatomic variations determine the distal extent of the detubularizing incision. Care is taken to insure that the length of distal incision will correspond to the proximal incision once the pouch is created. The specimen bag is now removed transanally. The posterior walls of the sigmoid colon are anastomosed intracorporeally using a running 3-0 polyglyconate suture. This forms the posterior plate of the pouch.

Native sigmoid fixation facilitates intracorporeal suturing (Fig. 5).

0 0

Post a comment