Locally Advanced Cancer of the Ascending Colon - Laparoscopic Right Colectomy with Complete Mesocolic Excision

Background: Complete Mesocolic Excision (CME) in colon cancer surgery seems to improve oncological outcome. CME is technically demanding with increased risks of vascular injury. Study Design: a 51-year old female patient with a bulky cancer of the ascending colon undergoes a laparoscopic right colectomy with CME. The key-points of the CME procedure are shown in the video (https://youtu.be/kKAKxZBLFDc). Technical Notes: A caudal-to-cranial and medial-to-lateral approach is used. Adequate dissection of the Toldt’s plane, complete exposition of the superior mesenteric vein, and opening of the right part of the gastro-colic ligament with complete detachment of the duodenum-pancreas from the transverse mesocolon are the key-points to perform a safe CME. Conclusion: At final pathology the stage of the cancer was pT3N1bM0 (3 positive lymph nodes out of 52 harvested). Postoperative stay was uneventful.