Cannula Positioning

Cannulas should be positioned in a half circle or line facing toward the site of pathology. Thus, for jejunal surgery, the half circle will open toward the right upper quadrant (Figure 8.1.2), whereas for ileal surgery,

Suprapubic Quadrant
Figure 8.1.2. Position of the cannulae for ileal resection. For jejunal surgery, the left- and right-sided cannulae may suffice. For ileal surgery, it may be preferable to use the suprapubic cannula and omit the right lower quadrant one.

it will open toward the left upper quadrant. In many cases, only 2-3 cannulae are used to accomplish a diagnostic laparoscopy and to localize the pathology. A fourth cannula in the suprapubic area may be helpful in certain cases and should be placed readily if this may be helpful for retraction or exposure. Alternatively, for ileal surgery, the suprapubic cannula may be preferable and the right lower quadrant one may be eliminated.

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