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Updated: May 20, 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
Hybrid NOTES colectomy for right-sided colonic tumors.
T P P Cheung1, H Y S Cheung, L W C Ng
1Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China. tppcheung@hotmail.com
Asian Journal of Endoscopic Surgery
|July 11, 2012
Summary
Hybrid NOTES right hemicolectomy, a novel surgical approach, demonstrates safety and feasibility. This technique facilitates specimen extraction via the transrectal route, enhancing minimally invasive colorectal surgery options.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Surgery
- Surgical Innovation
Background:
- Pure NOTES (Natural Orifice Transluminal Endoscopic Surgery) presents challenges in colorectal procedures due to limitations in surgical access and instrumentation.
- This study investigates the technical feasibility and clinical outcomes of a hybrid NOTES approach for right hemicolectomy, incorporating transrectal specimen extraction.
Observation:
- The hybrid technique involved mobilizing the right colon, ligating vessels, and performing an intracorporeal anastomosis using endostaplers.
- A Transanal Endoscopic Operations (TEO) device was utilized for transrectal specimen removal through a rectal enterotomy.
Findings:
- The procedure was successfully performed on a single patient, lasting 120 minutes with minimal blood loss (30 mL).
- The patient experienced an uneventful recovery, was discharged on postoperative day 5, and reported low pain scores (median 2).
Implications:
- Hybrid NOTES right hemicolectomy is a safe and feasible alternative to traditional laparoscopic surgery.
- This technique eliminates the need for a mini-laparotomy incision, advancing minimally invasive colorectal surgery.
- The approach shows promise for improving patient outcomes in the field of minimally invasive surgery.
