Laparoscopic Splenic Flexure Mobilization Using a Medial Approach.
- Author:
Hyoung Ran KIM
1
;
Yoon Suk LEE
;
In Kyu LEE
;
Jin Jo KIM
;
Keun Ho LEE
;
Se Jung OH
;
Seung Man PARK
;
Seung Taek OH
;
Jun Gi KIM
;
Young Ha KIM
Author Information
1. Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. yslee@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Laparoscopy;
Splenic flexure mobilization
- MeSH:
Anesthesia, General;
Colon, Transverse*;
Head-Down Tilt;
Humans;
Korea;
Laparoscopy;
Ligation;
Lymph Nodes;
Medical Records;
Mesenteric Artery, Inferior;
Mesenteric Veins;
Mesocolon;
Middle Aged;
Mortality;
Omentum;
Pancreas;
Peritoneal Cavity;
Pneumoperitoneum;
Retrospective Studies;
Sex Ratio
- From:Journal of the Korean Society of Coloproctology
2006;22(4):250-254
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Splenic flexure mobilization in an anterior resection is a subject of controversy, but a tension-free anastomosis is needed in case of a low anterior resection or a coloanal anastomosis. Classical splenic flexure mobilization by means of the lesser sac opening is technically difficult in the laparoscopic era. METHODS: This study retrospectively analyzed the medical records and operation videos of 16 patients who underwent laparoscopic splenic flexure mobilization in Our Lady of Mercy Hospital, The Catholic University of Korea by using a medial approach. The operation procedure is as follows: Under general anesthesia, the patient was placed in the Trendelenburg position, after making pneumoperitoneum, the inferior mesenteric artery (IMA) and the inferior mesenteric vein (IMV) were ligated and divided. A medial-to-lateral mesocolon dissection was done, and the pancreas was dissected from the mesocolon of the transverse colon; then, the greater omentum was dissected. RESULTS: The mean age was 60 years old, and the male- to-female sex ratio was 9:7. The mean operation time was 293 minutes. The mean distal margin was 5.3 cm, and the mean number of harvested lymph nodes was 15. An anterior resection was done in 2 cases, a low anterior resection is 10 cases, and a coloanal anastomosis in 4 cases. The mean time from ligation of the IMA to splenic flexure mobilization was 45 minutes. There was no mortality or morbidity. CONCLUSIONS: Laparoscopic medial splenic flexure mobilization is a technically feasible and safe method.
