Laparoscopic resection of the transverse colon for cancer is still controversial.This video shows a radical laparoscopic resection of the transverse colon with ligation of middle colic vessels at their origin.

The patient is in reverse Trendelemburg.The plan of the superior mesenteric vessels is identified and the mesentery of transverse colon is opened. The right colic artery is identified. The middle colic vessels are isolated on both sides of the mesentery and divided at their origin at the level of the pancreas.

The transverse colon is divided extracorporally through a minilaparotomy and a hand sewn anastomosis is performed after mobilisation of the flexures.

Out of 443 laparoscopic elective colorectal resections for cancer, 8 were for cancer of the transverse. With the technique showed in the video mean operative time was 156+/-40 minutes; number of lymphnodes retrieved was 11+/-7, length of specimen 21+/-8cm. Mean follow-up is 21.8+/-26 months. Two stage IV died after 27 and 11 months; 1 stage IV is alive with disease (3 months follow-up);2 stages II and 3 stages III patients are disease-free.

The video shows a technique for laparoscopic radical resection of the transverse colon. Our results demonstrate that an adequate oncologic resection of the transverse is possible laparoscopically.