Creating myotomy with a laparoscopic myotome
A. The myotomy is created with a laparoscopic myotome. Make this incision relatively shallow. Traction is applied by a grasper through the righthand port.
Lateral traction on the splenogastric attachments
Once the lesser sac has been entered, lateral traction on the splenogastric attachments will allow exposure of the short gastric vessels. These can be clipped (as shown) or divided with the LCS. (Reprinted with permission from Salky BA, Edye M. Laparoscop
Subsequent dissection of mesenteric vessels
The small bowel segment chosen for resection has been suspended by traction sutures passed through the anterior abdominal wall. This facilitates subsequent dissection of mesenteric vessels and provides retraction without additional graspers or trocars.