Laparoscopic Right Colectomy with Complete Mesocolon Excision

Andrea Lucchi, MD, FACS; Maria Elena Cufari, MD; Francesco F. Monari, MD; Michele Grassia, MDD; Vincenzo Alagna, MD; Carlo Gabbianelli, MD; Pierluigi Berti, MD; Giuseppe Corbucci Vitolo, MD; Franco Vandi, MD

Product Details
Product ID: ACS-5545
Year Produced: 2018
Length: 10 min.


BACKGROUND: The concept of TME has been applied to colon cancer and complete mesocolic excision (CME) in conjuction with central vascular ligation (CVL) has been introduced as the surgical treatment for colon cancer. The introduction of CME has improved oncologic outcomes greatly in patients with colon cancer. The improved outcomes with CME can be attributed to underlying sound oncologic principles such as dissection through the proper plane of mesocolic excision, central vascular ligation, and sufficient length of proximal and distal margins. METHODS: We present a video of a laparoscopic right colectomy for right sided colon tumor. A 62 years old female without comorbidities, BMI=31 kg/m2, underwent a colonoscopy after positive fecal occult blood test: a sub-obstructing neoplasm of the right colon has been discovered. The biopsy revealed an adenocarcinoma. Ct scan findings: neoplasm of the right colon, some enlarged limph nodes of the mesocolon. RESULTS: The patient underwent a totally laparoscopic right colectomy with CME and CVL. Usually we prefer a medial to lateral approach. Lenght of surgery was 3 hours. We tried to apply ERAS protocol . NG tube was removed at the end of the procedure. On 1° POD the patient began to eat and walk. The patient has been discharged on 2° POD. Hystological findings: adenocarcinoma pT3N2MX G2. Specimen lenght was 31 cm, lymph nodes examined were 49 and 8 of them were metastatic.