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Techniques in Coloproctology

, Volume 18, Issue 9, pp 789–794 | Cite as

Terminology and nomenclature in colonic surgery: universal application of a rule-based approach derived from updates on mesenteric anatomy

  • J. C. Coffey
  • R. Sehgal
  • K. Culligan
  • C. Dunne
  • D. McGrath
  • N. Lawes
  • D. Walsh
Review

Abstract

Recent developments in colonic surgery generate exciting opportunities for surgeons and trainees. In the first instance, the anatomy of the entire mesenteric organ has been clarified and greatly simplified. No longer is it regarded as fragmented and complex. Rather it is continuous from duodenojejunal flexure to mesorectum, spanning the gastrointestinal tract between. Recent histologic findings have demonstrated that although apposed to the retroperitoneum, the mesenteric organ is separated from this via Toldt’s fascia. These fundamentally important observations underpin the principles of complete mesocolic excision, where the mesocolic package is maintained intact, following extensive mesenterectomy. More importantly, they provide the first opportunity to apply a canonical approach to the development of nomenclature in resectional colonic surgery. In this review, we demonstrate how the resultant nomenclature is entirely anatomic based, and for illustrative purposes, we apply it to the procedure conventionally referred to as right hemicolectomy, or ileocolic resection.

Keywords

Mesocolon Mesocolic excision Toldt’s fascia 

Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag Italia Srl 2014

Authors and Affiliations

  • J. C. Coffey
    • 1
    • 2
  • R. Sehgal
    • 1
    • 2
  • K. Culligan
    • 1
    • 2
  • C. Dunne
    • 1
  • D. McGrath
    • 1
  • N. Lawes
    • 1
  • D. Walsh
    • 1
  1. 1.Centre for Interventions in Infection, Inflammation and Immunity (4i), Graduate Entry Medical SchoolUniversity of LimerickLimerickIreland
  2. 2.Department of SurgeryUniversity Hospital Group LimerickLimerickIreland

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