The right colic artery is a branch of the superior mesenteric artery supplying the ascending colon. It is the most variable of the colic arteries, being absent in 5-18% of individuals and sometimes replaced by an accessory branch of the ileocolic. When present it ascends retroperitoneally to the hepatic flexure, dividing into ascending and descending branches that anastomose with the middle colic and ileocolic arteries in the marginal artery.
The right colic artery and its relationship to the superior mesenteric vessels is a key anatomical consideration in laparoscopic right hemicolectomy and ileocolectomy. Central vascular ligation at the SMA origin for right colon cancer requires precise identification of the right colic artery to ensure adequate lymph node harvest along the named vessel. The hepatocolic ligament and the relationship of the right colic to the duodenum and right gonadal vessels are important dissection landmarks. The right colic is at risk during retroperitoneal approaches to the right kidney.
Right nephrectomy, adrenalectomy, and iliac vessel surgery through a retroperitoneal approach risk injury to the right colic artery where it crosses the retroperitoneum, causing ischaemia of the ascending colon that may not be immediately apparent but produces delayed ischaemic colitis.
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