Laparoscopic-assisted complete mesocolic excision in radical right hemicolectomy

Abstract

Complete mesocolic excision of radical right hemicolectomy was performed as following: medial approach was employed and accurate interfacial space and sufficient lymph node dissection was highlighted in this operation. First, peritoneum was dissected along the anatomical position of ileocolic vessels, ileocolic vessels and the distal section of superior mesenteric vein (SMV) were then dissociated. Second, proximal section of SMV was exposed to the inferior margin of pancreas neck. Thereafter, the ileocolic vessels, the middle colic vessels and the right colic vessels were located. Third, after the dissection of lymph nodes along SMV, right Toldt’s fascia space was exposed from inside out. Next, the duodenum, the head of pancreas, the right side of SMV and Henle trunk were exposed. Finally, the right colon was dissociated by lateral procedure. Research indicated that this approach could ensure the D3 lymph node dissection, which was associated with the low local recurrence and distant metastasis, and the significant prolongation of overall survival. Key words: Colonic Neoplasms; Mesocolon; Laparoscopy; Complete mesocolic excision