How is the descending colon mobilized during laparoscopic left hemicolectomy?

Updated: Apr 13, 2020
  • Author: David B Stewart, Sr, MD, FACS, FASCRS; Chief Editor: Vikram Kate, MBBS, MS, PhD, FRCS, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS, FFST(Ed)  more...
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Answer

The descending colon can be easily mobilized as far proximally as the splenic flexure by continuing the same method of mobilization as discussed for the sigmoid colon. (See the video below.)

Laparoscopic left colectomy. Mobilization of descending colon.

The descending colon is retracted toward the anterior abdominal wall and the midline of the peritoneal cavity. The line of fusion between the posterior aspect of the colon mesentery and the retroperitoneum marks the line of dissection, allowing mobilization of the remaining left colon to the midline. The colon is retracted, and the line of fusion either is scored with electrical energy or is mechanically separated through tissue distraction. With proper retraction, this is a quick, bloodless process that does not require electrical energy to perform safely.


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