How to do it: Splenic flexure mobilisation via medial trans-mesocolic approach
Binura Buwaneka Wijesinghe Lekamalage1
, Anh Ngoc Vu2, Lucinda Jane Duncan-were1, Asiri Arachchi2, Andrew Bui2
1Clinic of General Surgery, Tauranga Hospital, Tauranga, New Zealand
2 Clinic of Colorectal Surgery, Austin Health, Melbourne, Australia
Abstract
Complete splenic flexure mobilization is a critical step in left-sided colorectal resections. Surgeons use three approaches-anterior, medial, and lateral-to divide peritoneal ligaments connecting the left colon. The decision to perform mobilization varies, with minimal impact on post-operative outcomes but longer surgery times and rare complications. Pancreatic injury risk is low, though other structures, like arteries and the duodenum, may be at risk. Our video outlines the medial trans-mesocolic approach, with the patient positioned in lithotomy. We expose the duodenal-jejunal flexure, ligate the inferior mesenteric vein, and perform medial to lateral dissection, completing splenic flexure mobilization. This video vignette outlines how to perform this technique for left sided colorectal resections.
Keywords: Laparoscopic surgery, colorectal, colorectal cancer, left hemicolectomy, anterior resection
Cite this article as: Lekamalage BBW, Vu AN, Duncan-were LJ, Arachchi A, Bui A. How to do it: Splenic flexure mobilisation via medial trans-mesocolic approach. Turk J Surg 2023; 39 (4): 387-388.
Externally peer-reviewed.
Concept - AA, AB, ANV; Design - ANV, LDW; Supervision - AA, AB, ANV; Materials - BBWL; Literature Search - BBWL; Writing Manuscript - BBWL, LDW; Critical Reviews - ANV, LDW, AA, AB, ANV
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.