Andrea Badillo

the most important thing, I think, though, is a good deep laparoscopic dissection into the pelvis so that you have very minimal transanal work to do. I think, unfortunately, you know, Jason and I and you and Aaron and Andrea see a lot of the morbidity associated with first-brown disease and the overstretching of the sphincters, which can be done if you do an extensive transanal amount of work, is really a morbidity that needs to be avoided. And laparoscopy helps with that.

do no harm to the dentate line nor to the sphincters.

Lone Star retractor pins should be placed in three positions: first at the skin to identify the dentate line, then advanced to cover the dentate line, then moved to the mucosal opening site as dissection proceeds superiorly.

Most defunctionalized colons can stay without needing irrigation access; only a small population will need the colon addressed if it becomes severely backed up with chalky stool.

To bring mid-transverse colon down for pull-through, the bowel must be de-rotated to avoid bringing the mesentery across the duodenum and creating obstruction.

For mid-transverse colon transition zone, the pull-through blood supply is based on right colic vessels, and the middle colic must be ligated.