This video vignette presents the case of a 67-year-old female with adenocarcinoma of the very proximal descending colon who underwent an entirely laparoscopic left extended hemicolectomy (LELC) with lap derotation of the right colon and colorectal anastomosis. Whilst lap extended right colectomy is well established procedure, LELC is rarely used (mainly for distal transverse or proximal descending colon carcinomas extending to the area of the splenic flexure). LELC presents several technical challenges (including splenic flexure full mobilization and resection, complete derotation of the right colon in order for the hepatic flexure to reach the pelvis and be anastomosed to the upper rectum) and is therefore difficult to perform. The video presents the steps needed to mobilize the left colon and procure a safe approach to the splenic flexure, when a tumor is closely related to it. It further showcases a laparoscopic complete mesocolic excision at the level of the Treitz ligament for the IMV and flush to the aorta ligation of the IMA, as well as the preparation for a colorectal anastomosis. Finally, it presents the rare instance when a complete laparoscopic derotation of the ascending colon with delivering of the fully rotated ascending colon and hepatic flexure through a suprapubic wound protector placed via a low mini-Pfannenstiel incision, is used to provide length for a tension free primary colorectal anastomosis.