A patient sustained traumatic injury to major abdominal vessels. It has been planned to explore the Suprarenal Aoa, the Celiac Axis, the Superior Mesenteric Aery, and the Left Renal Aery. Which maneuver is recommended for exposure of all these structures?
Since the patient in the question has sustained traumatic injury to major abdominal vessels, left medial visceral rotation would be the most appropriate maneuver to explore all the major abdominal vessels. In this technique, the entire length of abdominal aoa from the aoic hiatus to its bifurcation into the common iliac aeries is exposed. Ref: Oxford Desk Reference-Major Trauma page,Page 306; Mastery of Vascular And Endovascular Surgery By Gerald B. Zelenock, page 640.
Cranial visceral Rotation
Caudal visceral Rotation
Left Medial Visceral Rotation
Right Medial Visceral Rotation