Techniques in Coloproctology

, Volume 18, Issue 11, pp 1129–1131 | Cite as

Complete mesocolic excision and central vessel ligation for right colon cancers

  • S. Killeen
  • H. Kessler
Trick of the Trade


We describe our technique of complete mesocolic excision (CME) and central vessel ligation to ensure an intact mesocolic envelope and removal of all potentially involved lymph nodes for right colon cancers.


Lateral to medal mobilization: The dissection commences lateral by identifying Toldt’s line [1]. This embryonic fusion plane facilitates mesofascial and retrofascial separations. Anatomically and histologically, there is a single fascial layer separating the overlying mesocolon from underlying retroperitoneum. Hohenberger et al. [2] originally described duodenal kocherization but we do not routinely perform this maneuver. The mesenteric root up to the origin of the superior mesenteric pedicle is mobilized and the dissection is continued over the duodenum and pancreatic uncinate process to allow complete access to the superior mesenteric vein (SMV) and the medially and inferiorly placed superior mesenteric artery (SMA).

The autonomic nervous plexus is...


Superior Mesenteric Artery Superior Mesenteric Vein Central Lymph Complete Mesocolic Excision Radical Lymph Node Dissection 
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Conflict of interest



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Copyright information

© Springer-Verlag Italia Srl 2014

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryCleveland ClinicClevelandUSA

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