ANTERIOR resection of the rectosigmoid colon is sometimes indicated for malignant and benign tumors at or below the peritoneal reflection. Usually the location of the tumor in the bowel can be readily ascertained on abdominal exploration. Occasionally the tumor is quite small and the greater part of it is removed when the initial proctoscopic biopsy is done, or the tumor is quite soft and without much substance as may be the case with some villous papillomata. In either case it may be difficult to palpate these tumors during abdominal exploration with resulting uncertainty in choice of proper level of resection. This is especially true when one deals with obese patients who have a thick and indurated mesentery. We have found a rather simple maneuver helpful in dealing with such situations. This maneuver is illustrated in the Figure.
The patient is in a modified lithotomy position on the operating table
THORBJARNARSON B. Resection of Rectosigmoid for Small Tumors. Arch Surg. 1966;92(6):943. doi:10.1001/archsurg.1966.01320240131028