STEP 1Operative room positioningtrocar placement

The patient is placed under general anesthesia with orotracheal intubation.

A nasogastric tube and Foley urinary catheter are put in place.

Prophylactic parenteral antibiotics are given.

The patient is positioned in the lithotomy position with a wedge under the left flank (45° of elevation).

The surgeon stands between the patient's legs, the first assistant to patient's right, and the scrub nurse to the patient's left.

Two monitors are positioned at each of the patient's shoulders.

A five-trocar technique is used (10-mm trocar at umbilicus for 10mm, 30° laparoscope); the size and position of the other four trocars vary with patient habitus, but a 12-mm trocar in the left mid-axillary line is used to introduce the linear stapler.

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