Abstract
Background
Laparoscopic complete mesocolic excision (CME) for hepatic or splenic flexural colon cancer is considered technically demanding. The double (hepatic and splenic) flexural colon cancers are rare, and the laparoscopic CME procedure for such disease is not standardized.
Methods
This video presents laparoscopic CME for double (hepatic and splenic) flexural colon cancers using a medial and cranial approach.
Results
The patient was a 60-year-old woman with the diagnosis of splenic flexure cancer (cT4N1M0) and hepatic flexure cancer (cT3N0M0). Laparoscopic subtotal colectomy was performed. First, the left colic artery was divided at its origin, and the inferior mesenteric vein also was divided at the same level. The descending mesocolon was widely separated from the retroperitoneal tissues using a medial approach. Then, lymph node dissection along the surgical trunk was performed using a cranial approach. Finally, the transverse mesocolon was divided at the inferior border of the pancreas, and CME was achieved. The specimen was extracted through a small incision at the umbilicus, and side-to-side ileo-sigmoid anastomosis was performed extracorporeally.
Conclusions
The approach presented in the video might be useful for standardization of laparoscopic CME for double flexural colon cancers.
Article PDF
Similar content being viewed by others
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Matsuda, T., Hasegawa, H., Yamashita, K. et al. Laparoscopic Complete Mesocolic Excision for Double Flexural Colon Cancers. Ann Surg Oncol 26, 2516 (2019). https://doi.org/10.1245/s10434-019-07329-4
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1245/s10434-019-07329-4