Laparoscopic Oncologic Splenic Flexure Resection: A Complete Mesocolic Excision with Concomitant Inferior Mesenteric...

Area of Science:

• Surgical Oncology
• Minimally-Invasive Surgery
• Gastrointestinal Surgery

Background:

• Left hemicolectomy with inferior mesenteric artery (IMA) preservation for colon cancer can lead to distal colon complications when the inferior mesenteric vein (IMV) is ligated.
• Concomitant IMA and IMV preservation may mitigate these complications.

Purpose of the Study:

• To demonstrate a minimally-invasive surgical technique for concomitant IMA and IMV preservation during splenic flexure resection for left-sided colon cancer.
• To evaluate the feasibility and oncological safety of this approach.

Main Methods:

• Step-by-step video demonstration of a minimally-invasive left hemicolectomy with IMA and IMV preservation.
• Procedure includes specific dissection planes, vessel ligations (left colic artery), and lymphadenectomy.
• Intracorporeal anastomosis and specimen retrieval.

Main Results:

• The technique is feasible in experienced hands.
• Successful preservation of both IMA and IMV was achieved.
• The patient experienced no postoperative complications and was discharged on postoperative day four.
• 24 lymph nodes were harvested, indicating adequate oncological resection.

Conclusions:

• Concomitant IMA and IMV preservation is technically feasible during minimally-invasive splenic flexure resections.
• This approach may reduce intestinal complications in the distal colon.
• Oncological outcomes are not compromised by preserving the IMV.