Medial-to-Lateral Approach to the Splenic Flexure Resection and End Transverse Colostomy: A Case Report and Operative Video.

Splenic flexure cancer is relatively rare among colon cancers. We present a case of a 76-year-old female with a partially obstructing tumor in the proximal descending colon and pulmonary metastasis who underwent a laparoscopic resection of the splenic flexure with end transverse colostomy due to clinical symptoms of obstruction. This case highlights several important technical considerations in safely performing the laparoscopic resection of the splenic flexure through the medial-to-lateral approach starting at the plane below the inferior mesenteric vein (IMV), taking care to preserve the tail of the pancreas. We present a narrated video demonstrating our approach, taking care to highlight important anatomic landmarks.