The maneuver starts by incising the periduodenal peritoneum about 1 cm from the lateral duodenal margin. By gently pulling the bowel mediad the assistant puts traction on it. Lift the parietal peritoneum at the level of the mid-duodenum and incise it with scissors. Carry the dissection along the duodenum and posterior to it in the loose layer of the tela subserosa.
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Incising the periduodenal peritoneum
![Incising the periduodenal peritoneum]()
Mobilizing the duodenum
Mobilize the duodenum as usual from its lateral aspect. This first exposes the inferior vena cava a
Mobilize the duodenum as usual from its lateral aspect. This first exposes the inferior vena cava a
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