Colon Resection mayo stand and back table surgery setup

Colon resection, also known as colectomy, is a surgical procedure to remove a portion of the colon (large intestine). It is typically performed to treat conditions such as colon cancer, diverticulitis, inflammatory bowel disease, or bowel obstruction. During the procedure, the affected section of the colon is removed, and the remaining parts are reconnected. In some cases, a colostomy bag may be necessary temporarily or permanently to divert waste from the body while the remaining parts of the colon heal. Colon resection is a major surgery and requires careful preparation and aftercare.

Extra Equipment
ESU, suction

Drapes
Folded towels, laparotomy drape

Step 1: Incision and Access
An incision is made to expose the small bowel, typically using a 10 blade. The abdominal cavity is opened and explored to locate the affected part of the small bowel.

Step 2: Dissection and Hemostasis
The mesentery is dissected and cut into, ensuring hemostasis is maintained throughout the procedure. Hemostatic instruments such as clamps, bipolar forceps, and LigaSure may be used.

Step 3: Resection
The affected part of the small bowel is identified and removed. A TA (linear cutter) or GIA (circular stapler) may be used to connect the two ends of the small bowel back together. The resected piece of small bowel should be handed off as a specimen.

Step 4: Hemostasis and Closure
After hemostasis is ensured, the surgical site is closed in layers. Suture material such as Vicryl or Monocryl may be used to close the tissue layers. Hemostatic agents, such as Surgicel or Floseal, may also be used to control bleeding. The final layer of closure is typically the skin.

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.

The Surgery Sparknotes

1. Incise small bowel with 10 blade.
2. Cut and dissect mesentery while maintaining hemostasis.
3. Locate and remove affected part of small bowel.
4. Connect two ends of small bowel with TA or GIA stapler.
5. Hand off resected piece as specimen.
6. Ensure hemostasis before beginning closure in layers.