Right medial visceral rotation

• Procedure
  • Mobalise the hepatic flexure and ascending colon via dividing the line of Toldt
  • Then mobilise the SB mesentery from caecum/RLQ to ligament of Treitz and reflect right colon to LUQ
  • Then Kocherise the Duodenum
• Provides exposure to
  • Entire duodenum - particularly D3 and D4
    • Accessing D3 with SM vessels there
    • Need to be retracted upwards
  • Pancreas - Head, neck and proximal body
  • Access to IVC and renal vessels
  • Right kidney