ABSTRACT
The first laparoscopic colonic resection was reported in 1991, and since then interest in the techniques involved has skyrocketed. The indications for laparoscopic sigmoid colectomy and high anterior resection include colorectal carcinoma, endoscopically unresectable adenomatous polyps, sigmoid volvulus, inflammatory bowel disease, ischaemic colitis, and strictures and diverticular disease. Standard equipment should include a high-definition laparoscopic stack, a 30º10-mm laparo-scope, laparoscopic scissors, diathermy hook, atraumatic bowel grasping forceps, and suction/irrigation. In theatre, the patient is placed in the low Lloyd-Davies position, either on a beanbag or with shoulder and side supports to prevent movement during the operation as considerable tilting and head-down positioning of the operating table is used to facilitate surgery. Correct orientation of the descending colon is then confirmed and torsion excluded as well as again ensuring that there is sufficient length for a tension-free anastomosis.
