Figure 1: Laparoscopic left mesenteric approach. Following the Treitz ligament and transverse mesocolon are cut, the jejunum is passed to the supracolic compartment on the left side of the Supra-Mesenteric Artery (SMA). The jejunum is then retracted to the left. While the assisting surgeon gently retracts the SMA to the right, the nerve plexus and blood vessels between the head of the pancreas and SMA are clearly exposed (Figure 1a). Following the jejunum is transected, the mesojejunum and mesoduodenum are resected on the border between transversemesocolon and those mesenteries toward the root of the media-colic artery by vessel sealing system or tissue sealing device (Figure 1b).