Laparoscopic S7 and S4 segmentectomy combined with transverse colon resection for synchronous metastatic colorectal...

Simultaneous laparoscopic resection of colorectal cancer (CRC) and synchronous liver metastases (SLM) remains a surgical challenge, especially when lesions involve posterosuperior liver segments. We present a case of a 42-year-old male with a transverse colon adenocarcinoma with SLM in segments 7 and 4. A simultaneous laparoscopic procedure was performed: anatomical liver resections in a modified left jack-knife position followed by transverse colectomy in the supine position. In-flow and out-flow blood control was achieved using intracorporeal Pringle manoeuvre and right hepatic vein tourniquet. The patient initiated a chemotherapy regimen with capecitabine and oxaliplatin (CAPOX) postoperatively and remained recurrence-free at 8 months. This case demonstrates the feasibility and safety of simultaneous laparoscopic resection for CRC with limited SLM involving challenging hepatic segments.