Laparoscopic Duodenal Diverticulectomy via the Inframesocolic Route

The duodenum is traditionally reached and dissected by an anterior approach. Optimal exposure is achieved via complete hepatic flexure mobilization and kocherization of the duodenum and head of the pancreas, which can be technically challenging and time-consuming, especially in the setting of minimally invasive surgery. On the contrary, an inframesocolic approach provides a ready and neat access to the second and third segments of the duodenum with distinct advantages in terms of exposure and operative time. This video presents the details of our laparoscopic technique of approaching the duodenum via the inframesocolic route, as performed to treat a patient with symptomatic duodenal diverticulum.