Right colonic arterial anatomy. Implications for laparoscopic surgery. Dis Colon Rectum 1996 Aug;39(8):906-11
Date
08/01/1996Pubmed ID
8756847DOI
10.1007/BF02053990Scopus ID
2-s2.0-0029768063 (requires institutional sign-in at Scopus site) 63 CitationsAbstract
PURPOSE: Hemorrhagic complications can be a major cause of conversion and/or morbidity during laparoscopic intestinal surgery. The limited exposure currently provided in laparoscopic intestinal resection demands a precise knowledge of mesenteric vascular anatomy to avoid such complications and to expedite the procedure. Most surgical texts depict a "normal pattern" of arterial supply to the right colon consisting of three arterial branches (ileocolic artery, right colic artery, and middle colic artery) arising independently from the superior mesenteric artery (SMA). Based on previous reports and clinical observations, we hypothesized that the right colic artery arises infrequently from the SMA, and most commonly, there are only two colonic arteries arising independently from the SMA.
METHODS: We performed detailed dissections of the SMA in 56 human cadavers.
RESULTS: We found the ileocolic artery in all of our cases and the middle colic artery in 55 of 56 cadavers but only six cases of a right colic artery emanating directly from SMA.
CONCLUSIONS: Our data, combined with review of published anatomic studies, lead us to conclude that in the vast majority of cases there are only two independent branches arising from SMA that supply the large intestine, the ileocolic and the middle colic arteries. The right colic artery directly arising from SMA is unusual (10.7 percent). This knowledge may help lower the risk of vascular complications during laparoscopic intestinal surgery.
Author List
Garćia-Ruiz A, Milsom JW, Ludwig KA, Marchesa PAuthor
Kirk A. Ludwig MD Chief, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultArteries
Blood Loss, Surgical
Cadaver
Colon
Female
Humans
Ileum
Intraoperative Complications
Laparoscopy
Male
Mesenteric Artery, Superior