Operative steps for major GI surgeries
1. Abdomen is opened from midline incision
2. Abdominal cavity is explored for metastasis especially liver and pelvis
3. Incisie the peritoneum along the white line of Toldt in the left paracolic gutter,
freeing the distal descending colon and the sigmoid from their developmental attachments
from the splenic flexure to the pelvic brim
4. Care is taken to displace the mesosigmoid from the left ureter, which is seen coursing
over the iliac vessels
5. The gonadal vessels should be protected in a similar way
6. The peritoneum over the medial aspect of the mesosigmoid is incised toward the
root of the inferior mesenteric artery to the level of the proposed ligation and
then downward toward the pelvis.
7. The inferior mesenteric artery distal to the left colic branch is then divided and ligated.
8.
This website is for writing surgical notes in case sheets after tiring surgeries
Whipple's Pancreaticoduodenectomy
