Ann Coloproctol.  2024 Jun;40(3):282-284. 10.3393/ac.2023.00661.0094.

Cranial-first approach for laparoscopic extended right hemicolectomy

Affiliations
  • 1Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea

Abstract

Complete mesocolic excision and central vascular ligation with D3 lymphadenectomy are important surgical principles for improving oncological outcomes in colon cancer. The cranial-first approach is a colonic mobilization–first approach to radical right hemicolectomy, which has several advantages, including early feasibility assessment, safe dissection from surrounding organs, preestablished inferior margin of lymph node dissection, and revelation of the tangible anatomy of the tributaries of the gastrocolic trunk. This video demonstrates the cranial-first approach to radical right hemicolectomy in a 66-year-old man with locally advanced cecal cancer.

Keyword

Colonic neoplasms; Colectomy; Mesocolon; Laparoscopy; Lymph node excision
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