Pararectal laparotomy

**Pararectal laparotomy.** This is the name of a surgical operation that consists of dissecting the anterior abdominal wall in the area of ​​pararectal tissue. Norepinephrine (scopolamine) can be administered before premedication to reduce sympathetic activity and hemodilution. The patient's position is achieved after raising the head to the left shoulder or the Thomsen maneuver. The patient lies as if inhaling, not fixed, with the torso pressed to the edge of the operating table, to the lower part of the chest. One arm of the patient is placed upward, supporting the head and breathing. Under spinal anesthesia, the patient independently exhales before entering anesthesia. Medicines are used to achieve analgesia, a muscle relaxant, and during surgery the anesthesiologist ensures that adequate techniques are performed to create the best conditions for access to instruments. A trocar connected to an electric drill is inserted into the abdominal cavity