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Updated: May 24, 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
Hand-assisted laparoscopic versus total laparoscopic right colectomy: a randomized controlled trial.
L W C Ng1, L M Tung, H Y S Cheung
1Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan Hong Kong SAR, China. ngwingchiulawrence@yahoo.com.hk
Summary
Hand-assisted laparoscopic colectomy (HALC) offers no significant advantages over total laparoscopic colectomy (TLC) for right-sided colon cancer. This study found similar outcomes in operating time, recovery, and survival rates between the two laparoscopic techniques.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Laparoscopic colectomy for colorectal cancer offers short-term benefits but can be limited by reduced tactile feedback and longer procedure times.
- Hand-assisted laparoscopic surgery (HALC) was developed to improve tactile sensation during laparoscopic procedures.
- There is ongoing debate regarding the superiority of HALC versus total laparoscopic colectomy (TLC).
Purpose of the Study:
- To compare the efficacy and safety of hand-assisted laparoscopic colectomy (HALC) with total laparoscopic colectomy (TLC) for right-sided colon cancer.
- To evaluate operative outcomes, postoperative recovery, and long-term survival in patients undergoing HALC versus TLC.
Main Methods:
- A randomized controlled trial was conducted involving adult patients with carcinoma of the caecum and ascending colon.
- Patients were randomized to undergo either HALC or TLC.
- Outcomes measured included operative time, blood loss, conversion rate, morbidities, pain, hospital stay, disease recurrence, and survival.
Main Results:
- Sixty patients (30 HALC, 30 TLC) were recruited, with comparable demographics and histopathological staging.
- No significant differences were found between HALC and TLC in operative time, blood loss, conversion rates, pain scores, or length of hospital stay.
- With a median follow-up of 27-33 months, disease recurrence and 5-year survival rates were similar (83% vs. 80%, P=0.923).
Conclusions:
- Hand-assisted laparoscopic colectomy (HALC) is a safe and feasible technique for right hemicolectomy.
- HALC does not offer significant advantages over total laparoscopic colectomy (TLC) regarding operative time or conversion rates.
- Routine use of HALC for right hemicolectomy is not recommended based on these findings.
