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Updated: Feb 23, 2026
Surgical Trunk Oriented Laparoscopic Right Hemicolectomy (ST-LRH) for Right-Sided Colon Cancer
Published on: July 25, 2025
Three steps and a join: a simple guide to right- and left-sided medial to lateral laparoscopic colorectal surgery
M J F X Rickard1,2, A Keshava1,2, J W T Toh3,4
1Colorectal Division, Department of Surgery, Concord Hospital, Concord, NSW, 2139, Australia.
Background:
To provide a standardised 'medial to lateral' approach to laparoscopic colorectal surgery.
Methods:
Both right- and left- sided laparoscopic colorectal procedures were simplified into three well-defined steps and a join. An instructional video and procedural guide provides the important pearls and pitfalls in performing laparoscopic colorectal surgery.
Results:
During a 10-year period (2006-2016) at a single institution, 20 senior colorectal trainee surgeons and 20 general surgery registrars were trained in the 'three steps and a join' technique. Five hundred and sixty-eight laparoscopic anterior resections using this technique were performed. There were 5 (0.9%) leaks. Five hundred and forty-three laparoscopic right-sided resections were performed. There were 3 (0.6%) anastomotic leaks requiring reoperation and loop ileostomy.
Conclusions:
This step-by-step instructional video and procedural guide provides a simple and standardised approach which may be incorporated into a training pathway for laparoscopic right- and left-sided colorectal surgery.
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