Introduction: Right colectomy is often considered an easy and uninteresting procedure, not worth performing laparoscopically. Little specific literature is available.

Methods: The video details a right colectomy with primary high ligation of the ileo-colic and right colic pedicles, including extensive en-bloc lymphadenectomy alongside the superior mesenteric vein, for a cT4NxMx adenocarcinoma of the caecum in a 72 year old, white female. The anastomosis was done intraperitoneally, fully laparoscopically.

Results: Intraoperative bleeding was minimal (<60ml); no complications occurred. Postoperative recovery was uneventful, leading to an early (according to European standards) dismissal from hospital on day 7. Pathological findings showed G2 adenocarcinoma of the caecum, pT4N1M1(peritoneum), R0. A total of 38 lymph nodes were harvested during the procedure. The patient went on adjuvant FOLFOX regimen.

Conclusion: Laparoscopic right colectomy for cancer can achieve high standards. Adequate oncological resection including no-touch technique, primary vessel ligation, extensive lymph node retrieval and clear margins are clearly demonstrated. The true benefit might be less surgical trauma, and thus earlier delivery to adjuvant treatment when indicated. Secondary endpoints are less adhesions, making subsequent laparoscopic operations easier, either for recurrence or liver metastasis.