INTRAOPERATIVE MEASUREMENT OF COLONIC ANATOMY AND ATTACHMENTS WITH RELEVANCE TO COLONOSCOPY

This study examined the variations in colonic length and mesenteric at tachments in 118 patients undergoing laparotomy. Measurements were tak en according to a set protocol with the bowel pulled medially, or towa rds the pubic symphysis or the xiphisternum, mimicking the possible di splacements that may occur during colonoscopy. A free sigmoid loop was not present in 20 patients (17 per cent) because of adhesions. A desc ending mesocolon of 10 cm or more in length was recorded in ten patien ts (8 per cent) and an ascending mesocolon 10 cm or greater in 11 (9 p er cent). Some 24 patients (20 per cent) had mobile splenic flexures a nd in 34 (29 per cent) the mid-transverse colon reached the symphysis pubis or lower when pulled downwards. Mean (range) total colonic lengt h was 114.1 (68-159) cm. This study helps define anatomical variations that may affect the facility, or otherwise, of colonoscopy.