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Fundamentals of Rectal Cancer SurgeryFundamentals of Rectal Cancer Surgery

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Splenic Flexure Mobilization

Splenic Flexure Mobilization is a topic covered in the Fundamentals of Rectal Cancer Surgery.

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ASCRS U Education Portal is the one-stop place for all things related to colorectal surgery. Provided by the American Society of Colon & Rectal Surgeons. Powered by Unbound Medicine. Explore these free sample topics:

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Splenic flexure mobilization is often needed for a tension free colorectal anastomosis, especially for a low or coloanal anastomosis.[1] The 4 important maneuvers required for complete splenic flexure mobilization are:

  1. Division of the lateral splenic flexure attachments to the side wall
  2. Careful division of the splenocolic attachments with gentle traction
  3. Separating the omentum from the distal transverse colon and splenic flexure
  4. Complete mobilization of the distal transverse colon and descending colon mesentery off of the retroperitoneum.

Three approaches to splenic flexure release will be discussed below:[2]

  • Supramesocolic (or anterior) approach through the gastrocolic ligament
  • Inframesocolic (or medial) approach (Figure 4.1)
  • Lateral approach (Figure 4.2)

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Splenic flexure mobilization is often needed for a tension free colorectal anastomosis, especially for a low or coloanal anastomosis.[1] The 4 important maneuvers required for complete splenic flexure mobilization are:

  1. Division of the lateral splenic flexure attachments to the side wall
  2. Careful division of the splenocolic attachments with gentle traction
  3. Separating the omentum from the distal transverse colon and splenic flexure
  4. Complete mobilization of the distal transverse colon and descending colon mesentery off of the retroperitoneum.

Three approaches to splenic flexure release will be discussed below:[2]

  • Supramesocolic (or anterior) approach through the gastrocolic ligament
  • Inframesocolic (or medial) approach (Figure 4.1)
  • Lateral approach (Figure 4.2)

There's more to see -- the rest of this topic is available only to subscribers.

Last updated: November 22, 2021

Citation

"Splenic Flexure Mobilization." Fundamentals of Rectal Cancer Surgery, 2021. ASCRS U, www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831014/all/Splenic Flexure Mobilization.
Splenic Flexure Mobilization. Fundamentals of Rectal Cancer Surgery. 2021. https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831014/all/Splenic Flexure Mobilization. Accessed March 21, 2023.
Splenic Flexure Mobilization. (2021). In Fundamentals of Rectal Cancer Surgery https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831014/all/Splenic Flexure Mobilization
Splenic Flexure Mobilization [Internet]. In: Fundamentals of Rectal Cancer Surgery. ; 2021. [cited 2023 March 21]. Available from: https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831014/all/Splenic Flexure Mobilization.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Splenic Flexure Mobilization ID - 2831014 Y1 - 2021/11/22/ BT - Fundamentals of Rectal Cancer Surgery UR - https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831014/all/Splenic Flexure Mobilization DB - ASCRS U DP - Unbound Medicine ER -
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    • Fundamentals of Rectal Cancer Surgery
    • Background
    • Rectal Anatomy
    • Rectal Cancer Biology and Hereditary Cancer Syndromes
    • Rationale for Multi-Modality Therapy
    • Preoperative Issues
    • Preoperative Staging
    • Role of Tumor Board
    • Indications for Preoperative Neoadjuvant Therapy
    • Local Excision
    • Indications for LAR Versus Intersphincteric Resection Versus APR
    • Indications for Extended Resection
    • Preoperative Preparation
    • Interoperative
    • Patient Positioning and Equipment for Rectal Cancer Surgery
    • Inferior Mesenteric Artery
    • Inferior Mesenteric Vein (IMV)
    • Splenic Flexure Mobilization
    • Surgical Techniques for Length
    • Technique of Total Mesorectal Excision (TME)
    • Tailored Mesorectal Excision (TME)
    • Bowel Transection and Anastomosis
    • Indications for Fecal Diversion
    • Abdominoperineal Resection
    • Standardized Operative Report
    • Management of Intraoperative Vascular and Urinary Complications
    • Postoperative Issues
    • Rectal Cancer Pathology Assessment
    • Adjuvant Therapy for Rectal Adenocarcinoma
    • Surveillance After Rectal Cancer Treatment
    • Management of Local Recurrences
    • Short-Term Complications - Anastomotic
    • Short-Term Complications - Urinary
    • Ostomy Complications and Management
    • Long-Term Complications – Bowel Dysfunction
    • Long-Term Complications - Sexual Dysfunction and Its Management
    • Parastomal and Perineal Hernias
    • Impact of Postoperative Complications On Oncologic Outcomes
    • Course Complete
    • Final Assessment
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