Identification of the Inferior Mesenteric Vein

Fig. 11. The mesentery of the left colon is lifted from the fascia of Gerota underneath the inferior mesenteric vein

The IMV is identified at Treitz ligament level (Fig. 10). To facilitate the identification of the vein, the ligament of Treitz can be pulled carefully to the right. Once the IMV has been identified, the avascular plane between the vein and the fascia of Gerota is opened by sharp dissection and the mesentery of the left colon is detached from the retroperitoneum forming a sort of tent. The vein is clipped but not yet divided because delicate traction on it facilitates the sharp dissection along this plane (Fig. 11).

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