Single-port extraperitoneal right hemicolectomy with complete mesocolic -A human cadaveric study

Area of Science:

• Surgical Anatomy
• Minimally Invasive Surgery
• Oncologic Surgery

Background:

• Extraperitoneal access is established for left colectomies.
• Right-sided colectomy with complete mesocolic excision (CME) using this approach is not well-described.
• The EXPERTS (EXtraPEritoneal coloRecTal Surgery) with CME approach combines oncologic benefits of CME with extraperitoneal safety.

Purpose of the Study:

• To assess the anatomical feasibility, reproducibility, and visualization of critical structures for an extraperitoneal right hemicolectomy with CME.
• To evaluate the EXPERTS approach in accordance with the IDEAL framework (Stage 0).

Main Methods:

• A cadaveric study involving 11 dissections (9 Thiel-preserved, 2 fresh frozen).
• Assessment of anatomical feasibility, reproducibility, and visualization of key structures.
• Video recording and analysis of all dissections.

Main Results:

• Consistent identification of anatomical structures (kidney, duodenum, SMA, SMV) was achieved in 9 out of 11 cadavers via an extraperitoneal approach.
• Thiel-preserved cadavers offered better tissue quality and plane definition compared to fresh frozen.
• High-quality operative videos were obtained for analysis.

Conclusions:

• This IDEAL Stage 0 study confirms the anatomical feasibility of an extraperitoneal approach for right hemicolectomy with CME.
• The EXPERTS approach supports progression to clinical trials to evaluate safety and effectiveness.