Vascular anatomical variation in laparoscopic right hemicolectomy.

Area of Science:

• Surgical Anatomy
• Gastrointestinal Surgery
• Vascular Anatomy

Background:

• Laparoscopic complete mesocolic excision is the standard for colon cancer.
• Right colectomy presents challenges due to complex vascular anatomy.
• Central vascular ligation is key but difficult in right colectomy.

Purpose of the Study:

• To review and examine vascular variations during laparoscopic right hemicolectomy.
• To provide detailed anatomical information for surgical planning.
• To identify reliable anatomical markers for safe surgery.

Main Methods:

• Literature review of anatomical variations in laparoscopic right hemicolectomy.
• Classification of vascular variations based on branch location.
• Analysis of the prevalence and relationships of key vessels.

Main Results:

• Ileocolic artery (ICA) and middle colic artery (MCA) are usually present.
• Right colic artery (RCA) presence varies (12-45%).
• Ileocolic vein (ICV) is consistent; right colic vein (RCV) is often absent (up to 80%).
• Gastrocolic trunk (GTH) is present in nearly 80% of cases.
• Common variations include gastrocolic trunk (GCT) and gastro-epiploic colic trunk (GPCT).

Conclusions:

• Detailed knowledge of right-sided colonic vascular variations is vital for surgeons.
• Failure to identify variations can lead to intraoperative bleeding.
• The ileocolic vein (ICV) is recommended as a reliable anatomical landmark during surgery.