![]() The lateral attachments of the spleen are taken down first, with the goal of rotating the left upper quadrant viscera anteromedially. For tissue dissection, we employ the hook monopolar cautery and an energy-based tissue sealing or dividing device. It is advisable to leave at least 5 cm (4 fingerbreadths) between each port to minimize external interference of the laparoscopic instruments. The ports are equally distributed along the costal margin, with the posterior port placed as far lateral-posterior as permitted by the position of the colon ( Fig. We generally use three radially dilating trocars, and a fourth may be added in cases in which the spleen and pancreatic tail require additional retraction. ![]() This can be performed with the Veress technique or using an optical trocar in most cases. Initial peritoneal access is achieved 2 cm inferior to the costal margin in the midclavicular line (Palmer point). Townsend JR., MD, in Sabiston Textbook of Surgery, 2022 Left adrenal
0 Comments
Leave a Reply. |