Three-plane Model to Standardize Laparoscopic Right Hemicolectomy with Extended D3 Lymph Node Dissection
Sergey K Efetov1, Arcangelo Picciariello2, Inna A Tulina3
1Colorectal Surgery, Department Head, Department of Surgery, Clinic of Colorectal and Minimally Invasive Surgery, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Surgical Technology International
|December 11, 2019
Summary
This study introduces a three-plane model for laparoscopic right hemicolectomy. The anterior medial-to-lateral (aM-to-L) and caudal-to-cranial (Ca-to-Cr) approaches showed similar short-term outcomes, suggesting the model aids surgical insight.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Colorectal Surgery
Background:
- Laparoscopic right hemicolectomy is a standard procedure for colon cancer.
- Optimal surgical approach for accessing superior mesenteric vessels remains an area of interest.
- Standardized surgical models can improve procedural clarity and outcomes.
Purpose of the Study:
- To develop a novel
- three-plane model
- for laparoscopic right hemicolectomy.
- To compare short-term surgical outcomes between anterior medial-to-lateral (aM-to-L) and caudal-to-cranial (Ca-to-Cr) retroperitoneal tunneling access methods.
- To assess the utility of the three-plane model in guiding surgical technique.
Main Methods:
- A three-plane model was conceptualized to delineate surgical steps.
- Consecutive patients undergoing laparoscopic right hemicolectomy for colon cancer were analyzed.
- Outcomes were compared between patients operated using the aM-to-L approach and the Ca-to-Cr approach.
Main Results:
- Sixty-two patients were analyzed (29 aM-to-L, 33 Ca-to-Cr).
- No significant differences were observed in operative time, estimated blood loss, length of hospital stay, or lymph node yield between the groups.
- Baseline patient characteristics were comparable between the two surgical approaches.
Conclusions:
- The surgical approach to superior mesenteric vessels in laparoscopic right hemicolectomy with D3 lymph node dissection does not impact short-term outcomes.
- The proposed three-plane model offers valuable insights for surgeons performing this procedure.
- The study validates the safety and efficacy of both compared access methods within the framework of the new model.
