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"How I do it"--radical right colectomy with side-to-side stapled ileo-colonic anastomosis
M Hübner1, D W Larson, B G Wolff
1Department of Surgery, Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Summary
This study details a standardized five-step technique for oncological right colectomy and a three-step stapled anastomosis, aiming for reproducible outcomes and low complication rates in surgical training.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Colorectal Surgery
Background:
- Standardized surgical techniques are crucial for consistent clinical outcomes, particularly in academic medical centers.
- Reproducibility of surgical procedures enhances patient safety and training efficacy.
Purpose of the Study:
- To provide a detailed description of a well-established surgical approach for oncological right colectomy.
- To standardize the technique for improved results in teaching institutions.
Main Methods:
- A five-step lateral-to-medial dissection mobilizes the right colon, starting from the terminal ileum and including hepatic flexure takedown.
- Ileocolic vessels and mesocolon are divided after mobilization.
- Intestinal continuity is restored using a side-to-side stapled technique with a linear cutting stapler for both anastomosis and specimen extraction.
Main Results:
- The described technique facilitates learning and reproduction among surgical trainees.
- Adherence to technical details is associated with optimal oncological results.
- The stapled anastomosis technique is linked to a consistently low anastomotic leak rate, approximately 2%.
Conclusions:
- A standardized five-step lateral-to-medial dissection and a three-step side-to-side stapled ileo-colonic anastomosis are effective and reproducible.
- This approach aids in achieving excellent oncological outcomes and minimizing anastomotic leaks.
