The Mesocolon

Abstract

Background: Colonic mobilization requires separation of mesocolon from underlying fascia. Despite the surgical importance of planes formed by these structures, no study has formally characterized their microscopic features. The aim of this study was to determine the histological and electron microscopic appearance of mesocolon, fascia, and retroperitoneum, prior to and after colonic mobilization. Methods: In 24 cadavers, samples were taken from right, transverse, descending, and sigmoid mesocolon. In 12 cadavers, specimens were stained with hematoxylin and eosin (3 sections) or Masson trichrome (3 sections). In the second 12 cadavers, lymphatic channels were identified by staining immunohistochemically for podoplanin. The ascending mesocolon was assessed with scanning electron microscopy. The above process was first conducted with the mesocolon in situ. The mesocolon was then surgically mobilized, and the process was repeated on remaining structures. Results: The microscopic structure of mesocolon and associated fascia was consistent from ileocecal to mesorectal level. A surface mesothelium and underlying connective tissue were evident throughout. Fibrous septae separated adipocyte lobules. Where apposed to retroperitoneum, 2 mesothelial layers separated mesocolon and underlying retroperitoneum. A connective tissue layer occurred between these (ie, Toldt's fascia). Lymphatic channels were evident both in mesocolic connective tissue and Toldt's fascia. After surgical separation of mesocolon and fascia both remained contiguous, the fascia remained in situ and the retroperitoneum undisturbed.Conclusions: The findings demonstrate that the contiguous mesocolon and retroperitoneum are separated by mesothelial and connective tissue layers. These properties generate the surgical planes (ie, meso-and retrofascial planes) exploited in colonic and mesocolic mobilization.

Meraque/San Jiao of Eastern Medicine in Comparison with the Mesentery System Presented in Western Medicine

“…These studies [3,19,20,21] confirm our theory that the posterior wall of the abdomen and the mesentery are different parts of an organ called the Meraque organ or system.…”

“…Based on the mesentery system [1], there is a separation between the mesentery, the intestines, and the posterior wall [3,19,20,21], but according to our suggested organ, there is a contiguity between them. These studies [3,19,20,21] confirm our theory that the posterior wall of the abdomen and the mesentery are different parts of an organ called the Meraque organ or system.…”

“…Nevertheless, terms and statements, such as “discrete entity” [1], “mesenteric contiguity” [20], “it is feasible that the intestine and mesentery are contiguous from the diaphragm to the pelvic floor” [21], the mesentery and related structures [3], and the mesentery is an organ between the body system and the intestines [21], all indicate that this system may be a section of a multi-section organ which has not been described yet [unpubl. data].…”

Laparoscopic Complete Mesocolic Excision via Reduced Port Surgery for Treatment of Colon Cancer

“…The peritoneal membrane at the attachment site fuse and degenerate to form membranous connective tissue called the fusion fascia [26,27]. Mike and Kano demonstrated a review of fascial composition of the abdominal cavity during laparoscopic surgery for colon cancer [28]. In their procedure, fusion fascia of Toldt was dissected and resected from the retroperitoneum.…”

Manejo osteopático del dolor de miembros inferiores en niños, asociado al crecimiento

“…25 En la osteopatía visceral se debe partir de una escucha local que nos guíe hacia alguna lesión en un órgano específico; en caso de encontrarla se debe tratar de manera individual con las técni-cas respectivas para el mismo. Se deben examinar la fascia de Told que es una fina capa de tejido conectivo que separa el mesocolón del retroperitoneo 52 , adherencias del peritoneo posterior, los flancos y las fosas ilíacas . La mejor forma de abordaje es levantar un poco la extremidad del lado que se va a examinar y con la mano contraria palpar el tejido en busca de zonas de resistencia, distensión, dolor o hipotonía, ya que la falta de armonía del tono de la pared muscular puede generar una cohesión visceral, inflamación o trastornos circulatorios y del trán-sito intestinal.…”