Vascular anatomy for right colon lymphadenectomy

Area of Science:

• Vascular anatomy
• Surgical anatomy
• Gastrointestinal surgery

Background:

• The superior mesenteric artery (SMA) typically originates left of the superior mesenteric vein (SMV).
• The ileocolic artery (ICA) and right colic artery (RCA) are branches of the SMA supplying the right colon.
• Understanding the spatial relationship between the ICA, RCA, and SMV is crucial for surgical dissection.

Purpose of the Study:

• To investigate the three-dimensional anatomical relationship between the ileocolic artery (ICA), right colic artery (RCA), and superior mesenteric vein (SMV) in the context of right colon vascular anatomy.

Main Methods:

• A cadaveric study was performed on 27 individuals.
• Detailed dissection and observation of the vascular anatomy of the right colon were conducted.

Main Results:

• The right colic artery (RCA) originated separately from the superior mesenteric artery (SMA) in 30% of cases and crossed the superior mesenteric vein (SMV) anteriorly or posteriorly.
• The ileocolic artery (ICA) was identified in all cases, crossing the SMV anteriorly in 33% and posteriorly in 67%.
• In cases where the RCA originated separately, the ICA was predominantly posterior to the SMV (88%).

Conclusions:

• The ileocolic artery (ICA) and right colic artery (RCA) exhibit variable pathways, crossing the superior mesenteric vein (SMV) on either its anterior or posterior side.
• Surgeons must consider these anatomical variations and dissect these vessels in conjunction with the SMV to ensure safe and effective procedures in the right colon.