Kocher Maneuver Duodenum. Themattox maneuver is mobilization of the descending colon to the midline to expose the abdominal aorta. The feeding vessels to the duodenum at this point were serially ligated. The exploration began in the right upper quadrant where the duodenum was mobilized with a generous kocher maneuver.
Reflect the duodenum and pancreatic head from retroperitoneum. For example to control hemorrhage from the inferior vena cava or aorta or to facilitate removal of a pancreatic tumour it is named for the nobel prize winning surgeon emil theodor kocher in vascular surgery it is described as a method to expose the aa abdominal aorta. Kocher manoeuvre is a surgical manoeuvre to expose structures in the retroperitoneum behind the duodenum and pancreas. A kocher maneuver is the dissection of the lateral peritoneal attachments of the duodenum to allow inspection of the duodenum pancreas and other retroperitoneal structures over to the great vessels.
As the layer between the inferior vena cava and the posterior aspect of the pancreas and duodenum is an avascular plane we can enter the dissection plane without influencing any important vessels.
Kocher maneuver 1. The pylorus is marked by a silk suture and a kocher maneuver is performed. Lift the parietal peritoneum at the level of the mid duodenum and incise it with scissors. At that point i opened the duodenum longitudinally through the pylorus and debrided the necrotic part of the duodenal wall and in the base of the ulcer there was a bleeding vessel and this was oversewn with silk sutures. James pickering 32 058 views.