Transverse Colectomy (Open, Laparoscopic, Robotic)

Procedure Snapshot

• Indication: Mid-transverse colon cancer or trauma.
• Expected duration: ___
• Special instruments: Staplers, energy device, retractor.

Step Workflow

1. Mobilize hepatic & splenic flexures.
2. Identify middle colic vessels → divide at origin from SMA.
3. Divide colon proximal & distal to lesion.
4. Create functional end-to-end anastomosis.

Key Pimp Questions

• Q: Main blood supply? Middle colic artery from SMA.
• Q: Margins for cancer? ≥ 5 cm proximal/distal (PMID 31943861).

Critical Anatomy

• Landmarks: SMA/SMV root, pancreas head.
• Danger zones: Middle colic vein to SMV.

Informed Consent Highlights

• Leak __ Bleeding __ Injury to duodenum/pancreas ___

Post-op Considerations

• ERAS; advance diet after flatus.

References

• Chassin’s, Colon chapter; Clinical Scenarios, Colorectal.
• Kawai 2020 (PMID 31943861).