[Critical update on the no-touch technique in colonic cancer using the grasping tie]

The time honoured strategy of "no-touch" in the surgery of colon cancer does not stand an anatomical and patho-physiological criticism, also on the basis of some results of the literature. The personal experience of the problem leads to the proposal of an alternative realization of the procedure, that is an up-to-date of the classic method, and is really worth and easy to be overall adopted. The suggestion is to seal bipolarly the colon tract with the tumour by mean of the original grasping tie from the very beginning of the operation, and then to temporarily clamp the mesocolon close to the gut, before going on with the surgical dissection, lymphectomy and exeresis as usual. This procedure is able to completely isolate from the first steps of the operation the affected tract of the colon, so opposing the possible spreading of tumour cells in the portal and in the systemic venous stream during the following surgical manipulations. The rationale of the proposal is that of a more efficacy of the "no-touch" strategy based on strict anatomical and patho-physiological considerations.