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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
Intracorporeal laparoscopic cecorectal anastomosis
Leopoldo Sarli1, Renato Costi, Vincenzo Violi
1Department of Surgical Sciences, Section of General Surgery and Surgical Therapy, Parma University, Medical School, Parma, Italy. leosarli@unipr.it
Summary
This study introduces an intracorporeal antiperistaltic cecorectal anastomosis (CRA) technique for laparoscopic subtotal colectomy. This modified approach is feasible and shows no postoperative morbidity in initial patient cases.
Area of Science:
- Minimally Invasive Surgery
- Colorectal Surgery
- Surgical Innovation
Background:
- Laparoscopic subtotal colectomy with extracorporeal antiperistaltic cecorectal anastomosis (CRA) was previously described.
- A need exists for refining intracorporeal techniques in laparoscopic colorectal procedures.
Purpose of the Study:
- To describe and evaluate a novel technique for intracorporeal antiperistaltic cecorectal anastomosis (CRA) during laparoscopic subtotal colectomy.
- To assess the feasibility and initial outcomes of this modified laparoscopic approach.
Main Methods:
- Modification of laparoscopic subtotal colectomy to incorporate an intracorporeal CRA.
- Technique involves advancing the cecum with the stapler anvil into the pelvis for anastomosis.
- Procedure performed in two patients.
Main Results:
- Successful implementation of the intracorporeal CRA technique in two patients.
- Operating times were 230 and 260 minutes.
- No postoperative morbidity was observed.
Conclusions:
- Intracorporeally performed antiperistaltic cecorectal anastomosis is a feasible modification for laparoscopic subtotal colectomy.
- This technique offers a potentially advantageous approach for selected colorectal surgeries.
