A laparoscopic right hemicolectomy with a primary vascular approach
Epublication WebSurg.com, Jul 2012;12(07). URL: http://websurg.com/doi/vd01en3748
Introduction: We present the case of a 54-year-old male with a 5cm villous adenoma at the ileocaecal valve with a focus of invasive carcinoma. Previous attempts at endoscopic mucosal resection were unsuccessful. Methods: The set-up consisted of two 10/12mm ports (sub-umbilical and left iliac fossa) and three 5mm ports (right iliac fossa, supra-umbilical and epigastric). The primary vascular approach initially consists of identification, ligation and division of the vessels (ileocolic, right colic and right branch of the middle colic) at their origin, retroperitoneal mobilization of the mesocolon, taking down of the hepatic flexure and completion of the mobilization of the caecum and lateral attachments. Conclusion: The primary vascular approach to laparoscopic right hemi-colectomy is achievable.