Application of transvaginal 3D laparoscopic radical operation of right colon cancer

Abstract

Objective To investigate the clinical value of 3D high-resolution laparoscope in transvaginal radical operation of right colon cancer. Methods A retrospective study was performed on thirteen patients. Who were operated by transvaginal 3D laparoscopic radical operation of right colon cancer in Huaihe Hospital of Henan University from October 2015 to February 2018. We take the middle approach, according to the principle of total colonic mesangial excision, treatment of blood vessels, dissection of lymph nodes, free right colon, colonic hepatic flexure and partial ileum mesentery, open the intestinal cavity at the end of the transverse colon and ileum, side to side anastomosis of ileal transverse colon by Endo-GIA. After the replacement of the nail, the incision and anastomosis of the ileum and transverse colon were completed. Incision of the posterior fornix of the vagina, the specimen was dragged out through the vaginal fornix incision through the protective sleeve.Suture the posterior fornix of the vagina by endoscopic suture. Results Among the thirteen female patients, the age was 58~76 (median 62), and the body mass index 20.8~34.5 (median 31) Kg/m2. Four cases of tumor were located in the colonic hepatic flexure, seven cases of ileocecal and 2 cases of ascending colon. All operation were successfully completed, and no case was converted to laparotomy. The operation time was 164~232 (median 176) min, intraoperative hemorrhage 50~200 (median 100) ml, 13~18 (median 14) of lymph node, 1.8~5.2 (median 2.8) days after operation, 6.3~9.2 (median 6.8) days after operation. There was no case of anastomotic bleeding, anastomotic leakage or intraperitoneal infection after operation. No local recurrence or distant metastasis was observed after 4~30 months follow-up. Conclusion Transvaginal 3D laparoscopic right hemicolon radical resection has certain advantages and does not affect the pelvic floor function. It is safe and feasible. Key words: Colonic neoplasms; Transvaginal; Right colon cancer; 3D laparoscopy; Natural orifice specimen extraction surgery; Pelvic floor function