Laparoscopic medial-to-lateral colon dissection: how and why.
Laparoscopic colectomy is a difficult procedure with a long learning curve. We describe in this study our technique for right- and left-sided laparoscopic medial-to-lateral colectomy. The medial approach involves division of the vascular pedicle first, followed by mobilization of the mesentery toward the abdominal wall, and finally freeing of the colon along the white line of Toldt. This approach allows immediate identification of the plane between the mesocolon and the retroperitoneum and renders the dissection fast and safe. Our series of 50 consecutive laparoscopic colectomies supports this concept. We believe that surgeons familiar with this technique will have an important tool in their armamentarium to circumvent some of the challenges of laparoscopic colectomy.
Pigazzi
Alessio
A
Department of General and Oncologic Surgery, City of Hope National Cancer Center, 1500 East Duarte Road, Duarte, CA 91010, USA. apigazzi@coh.org
Hellan
Minia
M
Ewing
Douglas R
DR
Paz
Benjamin I
BI
Ballantyne
Garth H
GH
D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000098:blood supply*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male