Intraoperative measurement of colonic anatomy and attachments with relevance to colonoscopy

Abstract

Abstract This study examined the variations in colonic length and mesenteric attachments in 118 patients undergoing laparotomy. Measurements were taken according to a set protocol with the bowel pulled medially, or towards the pubic symphysis or the xiphisternum, mimicking the possible displacements that may occur during colonoscopy. A free sigmoid loop was not present in 20 patients (17 per cent) because of adhesions. A descending mesocolon of 10 cm or more in length was recorded in ten patients (8 per cent) and an ascending mesocolon 10 cm or greater in 11 (9 per cent). Some 24 patients (20 per cent) had mobile splenic flexures and in 34 (29 per cent) the mid-transverse colon reached the symphysis pubis or lower when pulled downwards. Mean (range) total colonic length was 114.1 (68–159) cm. This study helps define anatomical variations that may affect the facility, or otherwise, of colonoscopy.