Laparoscopic left colectomy is a standardized procedure and a cornerstone of ERAS management. Nonetheless, in France in 2014, 45% of left colectomy was still performed by laparotomy. And yet the benefits of laparoscopic approach have been established for a long time: low mortality, low morbidity and reduction of hospital stay. With the use of the ERAS program all these benefits have been increased. In our institution we routinely perform ambulatory colectomy (>171 procedures) (B. Gignoux & al Annals of Surgery 2018). Our technique is a three-port surgery requiring only one assistant and the surgeon. The use of new energy devices simplifies surgery and reduces operating time. In this case we show how to use the Ligasure Hook (Medtronic) and the Signia Stapling (Medtronic) devices. Specimen extraction is carried out through the anterior vaginal wall.
The patient is a 65-year-old female, 160 cm, 67kg, BMI= 26.17, menopaused for 9 years. She was treated for right breast cancer in 1989. His brother (59 years old) was treated for a right colonic cancer and she has accepted a systematic colonoscopy. The gastroenterologist has removed a 2.5 cm polyp (24 cm from the anal verge) in the sigmoid colon. Histology found an infiltrated adenocarcinoma with an incomplete margin (pTsm1). As the patient was on holidays for a long time, a control coloscopy was performed 2 months later and no residual scar or residual tumor were found. The CT scan and TEP scan are normal.
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