Lengthening of small bowel mesentery: stepladder incision technique

American Journal of Surgery
Mirza Khurrum BaigSteven D Wexner

Abstract

The surgical option of choice in most patients with mucosal ulcerative colitis or familial adenomatous polyposis is restorative proctocolectomy with ileal pouch anal anastomosis. The tension-free anastomosis is one of the most critical steps but may be technically difficult or impossible in some patients because of shortened small bowel mesentery. Various techniques have been described to increase the length of small bowel mesentery. These techniques usually involve selective division of mesenteric blood vessels and meticulous dissection. We describe a new technique of stepladder transverse, transmesenteric incisions in the avascular windows of small bowel mesentery. This provides additional small bowel length without compromising blood supply to the pouch and a simple and safe method of increasing the length of small bowel mesentery. To date, no complications have been reported using this technique.

References

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Citations

Nov 11, 2011·World Journal of Surgery·B DauserF Herbst
Aug 22, 2014·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·X-R WuJ M Church
Apr 1, 2015·Journal of Pediatric Urology·T CserniA Dickson
Dec 13, 2016·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·G OhiraH Matsubara
Jun 8, 2018·Diseases of the Colon and Rectum·Amy L LightnerDavid W Larson
Jul 12, 2018·Diseases of the Colon and Rectum·Erkin İsmailMehmet Ayhan Kuzu
Jan 10, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·M CarvelloA Spinelli
Mar 16, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A SpinelliF Ris
Aug 29, 2021·Langenbeck's Archives of Surgery·Shanglei Liu, Samuel Eisenstein

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