Best approach for surgical repair of the injury to abdominal aoa above the level of renal aery involving superior aery, celiac trunk, and the suprarenal branch:
Left medial visceral rotation exposes entire length of abdominal aoa, celiac axis, proximal pa of mesenteric aeries and proximal left renal aery. Maneuvers for Retroperitoneal Exposure Kocher&;s Maneuvre Extended Kocher&;s Maneuver Mattox Maneuver Cattel-Braasch Maneuver Surgical maneuver to expose structures in the retroperitoneum behind the duodenum and pancreas Used for mobilization of duodenum Right sided medial visceral rotation Right colon and duodenum is reflected medially Exposes IVC, Infrarenal aoa, right renal aery and iliac vessels Recommended for drainage of Inframesocolic hematoma Left sided medial visceral rotation. Left sided viscera(Left Kidney, left colon, Spleen and Pancreas) are brought to midline Exposes entire length of abdominal aoa, celiac axis, proximal pa of mesenteric aeries and proximal left renal aery. Recommended for drainage of Central supra-mesocolic hematoma For extensive retroperitoneal exposure Right colon is fully mobilized and reflected medially Good option for exposure of the infrapancreatic segment Ref: Sabiston 20th edition Pgno: 1546
Right medial visceral rotation
Left medial visceral rotation
Right lateral visceral rotation
Left lateral visceral rotation
Vascular surgery