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Related Experiment Video

Updated: Jul 10, 2026

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
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Laparoscopic-assisted proctocolectomy using complete intracorporeal dissection.

Nicolás A Rotholtz1, María L Aued, Sandra M Lencinas

  • 1Colorectal Section, General Surgery Department, Hospital Alemán, 1640 Pueyrredón Ave., Buenos Aires, C1118AAT, Argentina. nrotholtz@hospitalaleman.com

Surgical Endoscopy
|November 21, 2007
PubMed
Summary

Laparoscopic proctocolectomy with an intracorporeal dissection and a small incision is a safe and feasible surgical option for ulcerative colitis (UC) patients. This technique minimizes the need for larger incisions, improving outcomes.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Ulcerative colitis (UC) management often requires proctocolectomy.
  • Traditional laparoscopic proctocolectomy frequently necessitates larger incisions (>5 cm).
  • Minimally invasive approaches aim to reduce surgical trauma and improve recovery.

Purpose of the Study:

  • To evaluate the feasibility and safety of laparoscopic proctocolectomy with ileoanal J pouch using a complete intracorporeal dissection.
  • To assess the efficacy of a single, small (4-5 cm) right lower quadrant (RLQ) incision for specimen extraction and stoma creation.

Main Methods:

  • Prospective data collection from UC patients undergoing laparoscopic proctocolectomy with ileoanal J pouch (August 2003 - December 2006).
  • Complete intracorporeal dissection using a medial-lateral approach for the colon and total mesorectal excision.
  • Specimen extraction and stoma creation through a 4-5 cm RLQ incision.

Main Results:

  • 47 procedures in 32 patients (mean age 34.5 years, 56% male).
  • Conversion rate of 10.6% due to specific surgical challenges.
  • Overall morbidity rate of 14.9% with no mortality; mean hospital stay of 4.8 days.

Conclusions:

  • Complete laparoscopic dissection for proctocolectomy in UC is technically feasible.
  • This approach offers a safe alternative for surgical treatment of ulcerative colitis.
  • The use of a single small incision for specimen retrieval is viable.