Answer:
Generally the flap is based on the right gastroepiploic artery and vein. The pedicle is dissected to the posterior pylorus to gain adequate length. Proximal ligation is not used to divide the pedicle until the recipient vessels are prepared.
-Midline or subcostal incision, enter peritoneal cavity.
-Omentum released from any adhesions and reflected over the stomach onto regions of the liver exposing paired posterior layers of omentum with the transverse colon.
-Posterior omentum is released from its attachments to the colon along its antimesenteric border.
-Return omentum to inferior abdominal cavity; short gastrics divided; left gastroepiploic artery and vein are ligated distal to their junction with the splenic artery and vein.
-Omentum mobilized to within 3 cm of the gastric pylorus.
-For microvascular transplant, the gastroepiploic artery and vein are dissected to the posterior pylorus as required by pedicle length.