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Clinical Anatomy Related to Laparoscopic Colorectal Surgery
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
David N. Naumann, Mark Dilworth, Sharad Karandikar
The transverse colon is suspended on its mesentery and therefore this must also be mobilized when performing left or right hemicolectomies. The root of this mesentery lies in front of the pancreas and is fused with the dorsal mesentery of the stomach during embryological development, forming the transverse mesocolon. This is directly posterior to the segment of greater omentum just inferior to the stomach (Figure 3.4). If the surgeon were to divide this part of the omentum, they would enter the lesser sac and the transverse colon would remain suspended on the transverse mesocolon, ready for ligation of appropriate vessels.
The Abdomen
Published in Kenneth D Boffard, Manual of Definitive Surgical Trauma Care: Incorporating Definitive Anaesthetic Trauma Care, 2019
The right colon is mobilized by taking down the hepatic flexure and incising the peritoneal reflection down the length of the right paracolic gutter. The colon is then reflected medially in a plane anterior to Gerota's fascia. If more exposure is required, the root of the mesentery can be mobilized by dividing the inferior mesenteric vein. Performance of a Kocher manoeuvre and medial mobilization of the duodenum and head of the pancreas will reveal the segment of vena cava immediately below the liver, and provide excellent exposure of the right renovascular pedicle.
Operative nomenclature
Published in John Calvin Coffey, Rishabh Sehgal, Dara Walsh, Mesenteric Principles of Gastrointestinal Surgery, 2017
J. CALVIN COFFEY, BILL HEALD, BRENDAN J. MORAN
Although the anatomic terminology has been dealt with in detail in Chapter 2, a list of terms and associated descriptions will be outlined here. Root of mesentery: The root of the mesentery occurs where the superior mesenteric artery emerges from underneath the pancreas. From this point, the entire mesentery distal to the duodenojejunal flexure fans out. Overall, it is packaged in a spiral conformation and compactly plicated at the intestinal margin (Figure 9.1).
Laparoscopic Pancreatectomy in Rats: The Development of an Experimental Model
Published in Journal of Investigative Surgery, 2022
José Marcus Raso Eulálio, Manoel Luiz Ferreira, Paulo César Silva, Juan Miguel Renteria, Andrei Ferreira Costa Nicolau, Thales Penna de Carvalho, Adrielle Rodas Fernandes, Julia Radicetti de Siqueira Paiva e Silva, Alberto Schanaider, José Eduardo Ferreira Manso
In summary, the pancreas of the rat has the following relevant anatomical landmarks:Considering its limits, the duodenum on the right, the stomach anteriorly, the spleen on the left, and the colon attached to the anterior face of the mesoduodenum.Considering its parenchyma, an intraperitoneal layer inside the omental pouch, with mobility from the spleen, duodenum and stomach.Considering its vascularization, the superior mesenteric vein and the superior mesenteric artery crosses the parenchyma posteriorly at the junction between the splenic and duodenal lobes receiving the arterial and venous tributaries. The splenic vessels follow the splenic lobe on its upper margin, from the hilum of the spleen to the root of the mesentery, where the splenic vein merges with the superior mesenteric vein to form the portal vein.Considering the ductal structure, the pancreatobiliary duct has its intrapancreatic path toward the second duodenal portion, directly receiving the lobular and lobar ducts. There is a major duodenal papilla, where the pancreatobiliary duct flows and several small ducts drains directly to the duodenum.
The mesentery: an ADME perspective on a ‘new’ organ
Published in Drug Metabolism Reviews, 2018
Aneesh A. Argikar, Upendra A. Argikar
As we know it today, the layers of parietal peritoneum combine to form peritoneal folds called the mesentery (Williams and Warwick 1980; Martini 2006). These fan-shaped peritoneal folds arise from the root of the mesentery located centrally in the abdominal cavity. The mesentery attaches and supports the colon and is collectively known as the mesocolon. Anatomically, the mesocolon is further subdivided in different regions, namely the transverse mesocolon, the sigmoid mesocolon, the mesoappendix, and the mesorectum. The mesentery connects the convoluted small intestine to the posterior abdominal wall. The mesentery provides stability to the stomach and the intestines, and also allows independent movement of the small intestine. A schematic representation of the mesentery is shown in Figure 1. The microscopic anatomy of mesocolon has been previously discussed elsewhere (Culligan et al. 2014). A top layer of surface mesothelium and a bottom layer of retroperitoneum have been documented. Between these layers, a deep mesothelium layer, Toldt’s fascia (a connective tissue layer), and a layer of retroperitoneal mesothelium have been established. Lymphatic tissue has also been observed in the Toldt’s fascia. The adipose tissue and lipids present in the greater omentum are a source of energy and insulate against heat loss from the anterior abdominal wall. Further micro-anatomical details on the mesentery were not available. The connective tissue in the mesenteries contains blood vessels, nerves, and lymphatics to and from the intestinal tract. The possibility of metabolism and transport during this passage of blood could have been overlooked until now or may have been lumped in with intestinal clearance.