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Updated: Jul 14, 2026
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Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
Published on: January 9, 2026
Laparoscopic medial-to-lateral colon dissection: how and why
Alessio Pigazzi1, Minia Hellan, Douglas R Ewing
1Department of General and Oncologic Surgery, City of Hope National Cancer Center, 1500 East Duarte Road, Duarte, CA 91010, USA. apigazzi@coh.org
Summary
This study presents a medial-to-lateral laparoscopic colectomy technique, simplifying dissection for surgeons. This approach enhances safety and speed in complex laparoscopic colorectal surgery.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Surgery
- Surgical Techniques
Background:
- Laparoscopic colectomy presents a significant learning curve for surgeons.
- Traditional surgical approaches can be challenging due to anatomical complexities.
Purpose of the Study:
- To describe a novel medial-to-lateral laparoscopic colectomy technique.
- To demonstrate the safety and efficiency of this approach in a clinical setting.
Main Methods:
- The medial approach prioritizes early division of the vascular pedicle.
- Mesentery mobilization follows, progressing towards the abdominal wall.
- Colon mobilization along the white line of Toldt completes the dissection.
Main Results:
- The medial approach facilitates rapid identification of the mesocolon-retroperitoneum plane.
- Dissection is rendered faster and safer.
- A series of 50 consecutive laparoscopic colectomies validated the technique's efficacy.
Conclusions:
- The medial-to-lateral laparoscopic colectomy technique offers a valuable method for surgeons.
- This approach helps overcome common challenges associated with laparoscopic colectomy.
- Familiarity with this technique can improve surgical outcomes and proficiency.
