TRANSMESOCOLIC APPROACH FOR ROBOTIC DUODENAL OPERATIONS

To achieve adequate surgical exposure of the third portion of the duodenum, the Cattell-Braasch maneuver or right colon mobilization is generally required. However, completing right colon mobilization via a robotic approach is technically demanding, and the surgical view of the duodenum is often limited. The transmesocolic approach utilizes an avascular window on the right side of the mesocolon, between the middle or right colic artery and the ileocolic artery, and can achieve excellent exposure of the third portion of the duodenum. In this video, we demonstrate our robotic transmesocolic approach, which we used in three cases of duodenal operations.