Splenic flexure mobilization is often needed for a tension free colorectal anastomosis, especially for a low or coloanal anastomosis. The 4 important maneuvers required for complete splenic flexure mobilization are:
- Division of the lateral splenic flexure attachments to the side wall
- Careful division of the splenocolic attachments with gentle traction
- Separating the omentum from the distal transverse colon and splenic flexure
- 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:
- Supramesocolic (or anterior) approach through the gastrocolic ligament
- Inframesocolic (or medial) approach (Figure 4.1)
- Lateral approach (Figure 4.2)
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Last updated: November 22, 2021
"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 December 9, 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 December 09]. Available from: https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831014/all/Splenic_Flexure_Mobilization.
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