外科ジャーナル

Laparoscopic Right Colectomy from Up to Bottom

Abstract

Radu Moldovanu

The laparoscopic right colectomy became a well-established technique in the surgical armamentarium of colorectal operations. It has well proved advantages: reduction in postoperative pain, time to return of bowel function, and length of hospital stay. Different studies have also proven its safety in colorectal adenocarcinoma, with equivalence in nodal harvest, recurrence rates, disease-free survival, and overall survival. We present herein the technique of laparoscopic right colectomy from “up” to “bottom”. Different anatomical and technical key-points are highlighted. The results of a short series of the first 11 cases are also presented: men to woman ratio: 8 to 3; mean age 53.72 ± 12.39 years old; BMI 26.18 ± 2.92 kg/m2; surgical time: 132.75 ± 16.43 minutes; mean harvest lymphnodes: 16.72 ± 3.17; tumor stage: pTis (N=2); pT1 (N=6); pT2 (N=2); pT3 (N=1). Laparoscopic right colectomy using the “up” to “bottom” approach is a feasible and safe technique and allows the mesocolon excision with outstanding number of harvest lymph nodes. The procedure can be performed in good conditions by a single surgeon with one assistant.