Theatre set-up & equipment

Y. Van NieuwenhoveUZGent - GIHK

Anesthetist

Abdominal team

Transanal team

Transanal tower

Abdominal tower

Airseal

Patient position• Abdominal part

– Lloyd Davis position– (Left arm in abduction)– Trendelenburg – right tilt

• Perineal part– Mobile leg supports– Perineal elevation

Synchronous / sequential ?• 2 teams (synchronous)

– Shorter and easier– 2 towers– 2 cameras– 2 hemostatic generators

• 1 team (sequential)– Less equipment required– Longer and less control

Abdominal team• Setup similar to left

colectomy• No linear stapler required• Surgeon/assistant right• Tower left flank• Normal insufflation

Perineal team• Starts later (peritoneal deflection)• Separated table• Tower at level of head• Surgeon and assistant between

legs• Airseal insufflation

Perineal table• Lonestar (or Galaxy) retractor• Gelpoint Path• Monopolar hook• Airseal trocar• Fenestrated grasper• Surgipro 0 small (26mm) needle (2 pcs)• “Peanut” cottons• Hemorrhoidal stapler with long detachable spike

Gelpoint Path• Dilatator• Access channel• Gelseal cap• 3 trocarts (only 2

needed)

Airseal• Valveless• Stable pneumoperitoneum

– In small spaces– with maximal suction

• Constant smoke evacuation• !don’t get liquid in filter!

Hemorrhoidal stapler• 33mm• Long spike to facilitate

transanal connection• Detachable spike• Comes with “Longo” retractor