Laparoscopic Right Hemicolectomy

Pre op CT scan
Cephazolin Flagyl
Low Lloyd Davies position
Laparoscpic Debakey to handle bowel
Harmonic scalpel preferably
Dissect caecum up to duodenum first (i.e inferomedial)
Use diathermy on maryland or mixter to dissect and diathermy at the same time if no harmonic
Plane is always closer to mesentery of colon than you think (i.e not in the areolar tissue. Avoid getting into retroperitoneal tissue)
Then roll colon medially to come across hepatic flexure
Middle colic vessels are the limitation of mobility
Pitfalls:
Duodenum
Ureter (if you see this you are way off)
Gonadal
Veins on front of pancreas
GB
Take ileocolic close to origin (the right colic is variable and not often present)
Test marginal blood supply
5cm margin from tumour
Betadine on bowel ends
Alexis wound retractor
Anastomosis based on luminal discrepancy
Minimal: hand sewn single layer interrupted PDS
Otherwise: Side-side stapled. Avoid T staple junction by anastomosing on rotated bowel