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Related Experiment Video

Updated: May 1, 2026

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
06:46

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection

Published on: January 9, 2026

533

Laparoscopic right hemicolectomy with complete mesocolic excision.

Jeonghyun Kang1, Im-kyung Kim, Sung Il Kang

  • 1Department of Surgery, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, South Korea, ravic@naver.com.

Surgical Endoscopy
|April 11, 2014
PubMed
Summary

Laparoscopic complete mesocolic excision (CME) for right colon cancer is feasible and safe. Identifying the superior mesenteric vein (SMV) early is key for safe dissection and oncologic outcomes.

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Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Colorectal Surgery

Background:

  • Complete mesocolic excision (CME) is a reemphasized surgical technique for colon cancer.
  • Laparoscopic approaches for right colon cancer present challenges in identifying dissection planes.
  • A modified lithotomy position and specific mobilization steps aid anatomical landmark identification.

Purpose of the Study:

  • To describe a standardized laparoscopic technique for complete mesocolic excision in right colon cancer.
  • To highlight the importance of identifying the superior mesenteric vein (SMV) for safe dissection.
  • To evaluate the feasibility and outcomes of this technique.

Main Methods:

  • Analysis of 128 consecutive patients undergoing laparoscopic CME for right colon cancer by a single surgeon.

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Last Updated: May 1, 2026

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
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Published on: January 9, 2026

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  • Standardized surgical approach involving ileocecal mobilization and cecal retraction.
  • Focus on identifying the SMV and middle colic artery (MCA) for precise dissection.

    • Main Results:

    • No conversions to open surgery were required.
    • Median operation time was 192 minutes.
    • Low postoperative complication rate (4.6%) and short median hospital stay (5 days).
    • Adequate resection margins and lymph node harvest were achieved.

    Conclusions:

    • Meticulous dissection along the SMV is crucial for oncologic safety in laparoscopic CME.
    • Early ileocecal mobilization and counter-traction facilitate SMV identification, especially for novice surgeons.
    • This technique provides a safe and effective approach for laparoscopic CME in right colon cancer.