Can We Reduce Ports While Preserving Outcomes? A Case Series of 3-Port Laparoscopic Right Hemicolectomy with...

Three-port laparoscopic right hemicolectomy has emerged as an intermediate minimally invasive technique aimed at reducing port number while maintaining operative safety, ergonomics, and oncological adequacy. Evidence regarding its feasibility and clinical outcomes remains limited.

A retrospective analysis was conducted on 42 consecutive patients who underwent 3-port laparoscopic right hemicolectomy with intracorporeal anastomosis for right-sided colon cancer between February 2023 and October 2025. Demographic characteristics, perioperative variables, postoperative recovery, complications, and pathological outcomes were evaluated.

The mean age was 66.5 years and the mean body mass index was 24.0 kg/m2. The hemicolectomy procedure was successfully completed using 3 ports in all patients. The mean operative time was 140 minutes, and the estimated blood loss was minimal, with no intraoperative transfusions. Oral intake resumed on postoperative day 1, and bowel function returned on the second day. The mean hospital stay was 7 days. Overall postoperative morbidity was 14.2%, consisting exclusively of minor complications; no anastomotic leaks or reoperations occurred. The mean lymph node yield was 22, with only 2 patients having fewer than 12 retrieved nodes; both of these patients had high-grade dysplasia rather than invasive carcinoma. All proximal and distal resection margins were oncologically adequate and microscopically negative.

Three-port laparoscopic right hemicolectomy with intracorporeal anastomosis is technically feasible, safe, and oncologically adequate. This approach enables a reduction in port number without increasing complications or compromising specimen quality. It may represent a practical alternative in centers aiming to optimize minimally invasive techniques while preserving operative efficiency.