A hole is made in the distal part of the mesentery of the transverse colon, above the tail of the pancreas (Figs. 16,17). This allows a flow of gas into the lesser sac and thus facilitates the separation of the omen-tum from the colon, which is taken down from the middle third of the transverse colon (Fig. 18). The assistant surgeon helps by pulling the transverse colon towards the pelvis with a grasper introduced in the left flank. The splenic flexure is then carefully detached from the spleen with the harmonic scalpel. If the patient is particularly tall or obese, this operation may be completed using the access in the left flank. At this point, mobilisation of the left colon is completed by detaching the residual peritoneal attachments in the left abdominal gutter.
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