Table 2.

Surgical steps in cholecystectomy, and left hemicolectomy combined with low anterior resection

Procedure	Surgical steps
Cholecystectomy	Retract gall bladder Dissect anterior and posterior reflections of peritoneum Dissect Calot’s triangle and establish critical view of safety Ligate and divide cystic artery and cystic duct Dissect gallbladder from liver Remove gallbladder through balloon bag
Left hemicolectomy combined with low anterior resection	Locate duodenum and divide inferior mesenteric vein Perform medial to lateral mobilisation over kidney Enter lesser sac over pancreatic body and separate mesocolon from body and tail of pancreas Divide omental attachment to left half of transverse colon, enter lesser sac from above and continue around to fully mobilise splenic flexure Isolate and ligate inferior mesenteric artery approximately 1 cm distal to origin from the aorta Mobilise sigmoid colon medial to lateral anterior to Toldt’s fascia, preserving the left ureter, and then release lateral attachments Dissect mesorectum in total mesorectal excision plane starting right and right posterior, moving round to the left from underneath Dissect mesorectum on right side, left side and then anteriorly in rectovaginal septum or posteriorly to prostate, either anterior or posterior to Denonvilliers’ fascia