The Operation Primer "Laparoscopic Sigmoidectomy for Cancer" refers especially to future surgeons, who wish to familiarize with minimal invasive colorectal surgery procedures. Besides, it is useful for experienced surgeons in open colorectal surgery who want to apply the minimally invasive technique.

Structure and handling of the Operation Primer

I Preparations for the operation
Instruments
Emptying the bladder
Positioning of the patient
Shaving
Neutral electrode
Setting the equipment
Skin disinfection
Sterile draping
Positioning of the operating team
II Creating the pneumoperitoneum - placing the optical trocar
a) Hasson Method (open technique), b) Trocar with obtical obturator, c) Veress needle (closed technique)
III Placing the working trocars
Placing the working trocars
IV Nodal points
1. Exploring the abdominal cavity
2. Identifying the anatomical landmarks
3. Mobilizing the left lateral colon
4. Mobilizing the splenic flexure
5. Dissecting the lymph nodes and the sigmoid mesentery
6. Dividing the inferior mesenteric vessels
7. Dissecting the upper mesorectum
8. Dividing the upper rectum
9. Extracting the sigmoid
10. Dividing the proximal colon and preparing the anastomosis extraabdominally
11. Preparing the anastomosis intraabdominally
12. Anastomosing the colon
13. Verifying the anastomosis
14. Finishing the operation
V Management of difficult situations, complications and mistakes
1. Adhesions. 2. Blood vessel injuries - a) Diffuse bleeding / bleeding from minor vessels, b) Bleeding from major vessels
3. Organ injuries - a) Greater omentum, b) Bowel, c) Spleen, d) Stomach, e) Liver and pancreas
4. Preperitoneal air emphysema - a) Veress needle, b) Trocar
5. Losing a swab in the abdominal cavity
6. Difficulties when identifying the inferior mesenteric artery
7. Adhesion of the sigmoid to the abdominal wall
8. Injury of the left sympathic trunk
9. Injury of the left ureter
10. Injury of the iliac vessels
11. Difficulties when clipping
a) Incorrectly positioned clips, b)Unsafely positioned clips, c) Lost and slipped clips
12. Positive anastomotic leak test
13. Rotation of the left colon
14. Spastic colon
15. Spread of tumour cells
VI Anatomical variations.-Vascular variations
Sigmoid position variations
Appendix
Sample operation note
Bibliography
List of key words.