Ultrasound-guided identification of superior mesenteric vein in robotic complete mesocolic excision for right colon cancer

Excerpt

The principle of complete mesocolic excision (CME) with central vascular ligation (CVL) for colon cancer has not been widely adopted due to concerns about increased morbidity and technical difficulties [1]. One of the challenges in CME surgery is the identification of the superior mesenteric vein (SMV) at the start of dissection and this is even more difficult in obese patients. A detailed knowledge of the anatomy is absolutely necessary [2], but the robotic platform can provide good views, access and the use of technology like intraoperative ultrasound to facilitate this step. Intraoperative Doppler ultrasound has been previously used for the identification of inferior mesenteric artery branches [3]. The procedure is shown in the attached video. …