- How
- Retract small bowel and descending colon to the right
- Mobilizing the left and sigmoid colon by incising the white line of Toldt
- Divide splenic attachement to the diaphragm
- Staying on the abdominal wall muscles enter the plane lateral and then posterior to the kidney medialising it
- Note - in elective surgery a left medial visceral rotation (not Mattox) is performed leaving the kidney down but rotating the spleen/colon/SB
- Left kidney is maintained in the Gerota’s fascia, in order to be protected from the traction injury, but the left renal vein hinders access to the anterior aorta.
- Exposure of
- Aorta and its branches
- Pancreas - distal body and tail
- Left Kidney
