Surgical Steps: Initial Exposure

• Instrumentation: 0°endoscope, laparoscopic bowel grasper left through right subcostal da Vinci port, 5 mm suction or laparoscopic bowel grasper right (assistant port) (if visualization is compromised, switch to a 30°endoscope down for a more topographical view).
• Retract small bowel loops out of the pelvic area into the right upper quadrant.
• Flip the greater omentum over the transverse colon towards the liver with laparoscopic instrumentation by the patient side assistant.
• In women, suspend the uterus using a suture through the fundus or around each ligament.
• Inspect the adbominal cavity for metastatic disease.
• Once sufficient initial exposure is achieved, dock the patient cart per "Docking" section.

1. Initial Exposure
2. Primary Vascular Control
3. Medial to Lateral Mobilization of Sigmoid & Descending Colon
4. Splenic Flexure Mobilization
5. Rectal Dissection & Division
• Posterior Dissection
• Lateral Dissection
• Anterior Dissection
• Rectal Division