Mayo stand and back table instruments for Bowel Resection (Colectomy/Hemicolectomy) surgery setup

Clamping & Occluding

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  Hemostatic Clip Applier

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  Curved Hemostat

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  Right Angle Clamp

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  Kocher Forceps

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  Kelly Forceps

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  Straight Hemostat

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  Babcock

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  Allis Forceps

Cutting & Dissecting

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  #3 Knife Handle

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  Metzenbaum Scissor

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  Curved Mayo Scissor

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  Straight Mayo Scissor

Grasping & Holding

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  Toothed Forcep

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  Smooth Adson

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  Adson Forceps

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  Russian Tissue Forceps

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  Forester Sponge Forceps

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  Ferris Smith Tissue Forceps

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  Non toothed Pickup

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  Debakey Forceps

Retracting & Exposing

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  Bookwalter Retractor

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  Balfour Retractor

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  Tessier Malleable Retractor

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  Army-Navy Retractor

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  Richardson Retractor

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  Deaver Retractor

Suctioning

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  Yankauer Suction

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  Poole Suction Probe

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Bowel Resection (Colectomy/Hemicolectomy)

A bowel resection surgery is a procedure where a part of the small intestine is removed and the remaining parts are reconnected. This is done to treat conditions such as cancer, Crohn’s disease, and diverticulitis, among others. The surgery is performed under general anesthesia and requires specialized instruments and a skilled surgical team to ensure its success.

Extra Equipment
ESU, suction 

Drapes
Folded towels, laparotomy drape

Step 1: Incision and Mesentery Dissection
The first step in a bowel resection surgery is making an incision to gain access to the small bowel. A 10 blade is typically used for this purpose. Once the incision is made, the mesentery is cut into and dissected. It is important to maintain hemostasis throughout this process to prevent excessive bleeding.

Step 2: Identification and Removal of Affected Small Bowel
After the mesentery is dissected, the affected part of the small bowel is identified and removed. This is typically done using either a TA or GIA stapler to connect the two ends of small bowel back together. The resected piece of small bowel should be handed off as a specimen for further analysis.

Step 3: Closure
Once the affected section of small bowel has been removed, closure begins in layers. The first layer of closure is typically the peritoneum, which is closed using a running absorbable suture. Next, the fascia is closed with interrupted non-absorbable sutures. Finally, the skin is closed using either a running subcuticular suture or staples.

Tips and tricks
Have long instrument trays available, as well as a Balfour and Bookwalter retractor. Always have different size clips easily accessible. The resected part of the bowel being removed should be kept separate in order to avoid contaminating the rest of the sterile setup. Any instruments that become contaminated with bowel contents should also be taken off of the sterile field. A separate sterile field may be requested for the end of the case for closing, containing extra gowns, gloves, and a minor procedure tray.

Scar after Hemicolectomy surgery

The Surgery Sparknotes

1. Make incision with 10 blade to access small bowel.
2. Cut and dissect mesentery while maintaining hemostasis.
3. Identify and remove affected small bowel using TA or GIA stapler.
4. Hand off resected piece as specimen.
5. Closure begins in layers: peritoneum, fascia, skin.