A standardized approach to laparoscopic colectomy can be applied to unique presentations.

In the past two years we have adopted a standardized approach to laparoscopic left and right colectomy using a hand assisted method (HALS). Using this approach makes the set-up of laparoscopic colectomy faster, allows all team members to better anticipate the surgery steps, it makes the surgery more efficient and decreases surgery time and cost. With less variation in equipment used, further cost savings are realized.

This patient presented with synchronous cancers in the cecum, transverse colon and rectosigmoid. She had a laparoscopic (HALS) subtotal colectomy and ileorectal anastomosis. Total surgery time was 3 hours and 10 minutes. She stayed 5 days in hospital without any complication.

Complex surgery such as laparoscopic colectomy can be standardized and simplified. The standardized surgical steps can be adapted to unique presentations such as this patient with three cancers. This approach increases surgical efficiency and can be taught to others wishing to learn how to perform laparoscopic colon resection.