Cannula Positioning

The cannulae are positioned in the umbilical region (above or below, depending on the size of the patient). If the patient is thin, just below the umbilicus is usually best. If the patient has a large and dependent pannus, somewhere above the umbilicus is better, usually about 23-25 cm above the symphysis pubis. Other cannulae are placed in the right and left upper and lower lateral abdominal wall. The proposed stoma site is not used for a cannula, because this is almost always located too far medial (Figure 8.6.2).

Laparoscopic Apr
Figure 8.6.2. Positions of the cannulae for the laparoscopic APR. Note that the proposed colostomy site is not used as a cannula site, because it is usually too close to the (optical) port through which the laparoscope is used.

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