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Updated: Jul 5, 2026

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
Published on: January 9, 2026
Laparoscopic right hemicolectomy for mucocele due to a low-grade appendiceal mucinous neoplasm
Chinnusamy Palanivelu1, Muthukumaran Rangarajan, Suviraj James John
1GEM Hospital, Ramnathapuram, Coimbatore, India.
Abstract:
Tumors of the appendix are rare entities causing mucoceles. The majority of them are discovered incidentally during investigation for other conditions. Laparoscopic surgery for appendiceal tumors is still controversial, as inadvertent rupture of the lesion due to improper handling will cause pseudomyxoma peritonei. The patient was incidentally discovered to have an appendiceal tumor and referred to us for laparoscopy. Because the tumor involved the entire appendix, a laparoscopic right hemicolectomy was performed without directly handling the tumor. Postoperative recovery was uneventful. Pathological diagnosis was low-grade appendiceal mucinous neoplasm. The safety of laparoscopic appendectomy for the management of incidentally discovered appendiceal tumors has not yet been established. Several reports in the literature support both laparoscopic and open surgery. The main concerns to be addressed are the adequacy of resection and intraperitoneal rupture of the tumor. Our patient successfully underwent laparoscopic surgery without any complications. A formal right hemicolectomy was performed because the tumor involved the entire appendix. We now think laparoscopic surgery for appendiceal tumors is safe, feasible, and even may be beneficial.
Insights
Appendiceal tumors are rare and often found incidentally. Laparoscopic surgery for these tumors is safe and feasible, even for extensive cases, reducing risks like pseudomyxoma peritonei.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Appendiceal tumors are rare, frequently presenting as mucoceles and often discovered incidentally.
- Laparoscopic surgery for appendiceal tumors remains controversial due to the risk of tumor rupture and subsequent pseudomyxoma peritonei.
Observation:
- A patient with an incidentally discovered appendiceal tumor involving the entire appendix underwent a laparoscopic right hemicolectomy.
- The procedure avoided direct handling of the tumor to minimize rupture risk.
Findings:
- The patient experienced an uneventful recovery following the laparoscopic right hemicolectomy.
- Pathological diagnosis confirmed a low-grade appendiceal mucinous neoplasm.
Implications:
- Laparoscopic surgery for appendiceal tumors, including hemicolectomy when necessary, appears safe and feasible.
- This approach may offer benefits in managing incidentally discovered appendiceal neoplasms while mitigating rupture risks.

