Surgical steps for splenic flexure mobilization by inframesocolic medial approach

Dynamic video showing the key steps for mobilization of the splenic flexure of the colon with a laparoscopic inframesocolic medial approach (Fig. 1):

• 1.

  Medial access below the inferior mesenteric vein (IMV).

• 2.

  High ligation of the inferior mesenteric artery.

• 3.

  Division of the left paracolic including the phrenicocolic ligament.

• 4.

  Ligation of the inferior mesenteric vein below the lower edge of the pancreas.

• 5.

  Medial inframesocolic approach with access to the omental cavity between the pancreas and the left mesocolon, which is left intact. The dissection of the adhesions of the left mesocolon to the pancreas is completed.

• 6.

  Division of the gastrocolic ligament.

• 7.

  Opening of the omental bursa and division of the splenocolic ligament.

Fig. 1.

Release of the splenic flexure with a laparoscopic inframesocolic medial approach.