New PDF release: Balanced Scorecard Report - The Strategy Execution Source -

By Robert S. Kaplan, David P. Norton

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Additional resources for Balanced Scorecard Report - The Strategy Execution Source - Volume 10 Number 6 - Nov-Dec 2008

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When this is accomplished, the fascia of Gerota and the perirenal fat may be gently swept from the posterior aspect of the right mesocolon. Continue 32 Right Colectomy for Cancer Fig. 2–8 Operative Technique (Right and Transverse Colectomy) this dissection caudally, eventually unroofing the ureter and gonadal vessel. Identification of Ureter If the location of the ureter is not immediately evident, identify the right common iliac artery. The undisturbed ureter generally crosses the common iliac artery where it bifurcates into its internal and external branches.

Resections, anastomoses, enterotomy repairs, and stricturoplasties are most easily performed extracorporeally through a limited incision, preferably midline to preserve future potential ostomy sites. Operative Technique OPERATIVE TECHNIQUE Room Setup and Trocar Placement After the induction of general anesthesia, the patient is placed in the modifi fied lithotomy position with the lower extremities in padded stirrups placed low for unimpeded movement of the instruments. Both arms are tucked at the patient’s sides and extra care is taken to secure the patient to the bed because of the rotation and tilt required during surgery.

3 –2a and 3 –2b). Initially, a 10 mm trocar is placed by the open Hasson technique in the supraumbilical position through which the camera is inserted. In the reoperative abdomen, the initial trocar can be placed in the left upper quadrant in a site remote from scars. The abdomen is insuffl flated to an intraabdominal pressure of 15 mm Hg. Two additional trocars are placed along the lateral edge of the left rectus muscle, 8–10 cm Fig. 3–1 44 Laparoscopic Right Hemicolectomy A B Fig. 3–2ab apart, in the midabdomen and iliac fossa positions.

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Balanced Scorecard Report - The Strategy Execution Source - Volume 10 Number 6 - Nov-Dec 2008 by Robert S. Kaplan, David P. Norton

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