Left colectomy with intracoporeal anastomosis: technical aspects

Abstract

Oncologic laparoscopic colectomy represents a fully validated surgical approach to the management of colorectal cancer. However, laparoscopic surgery for distal transverse and descending colon lesions remains a challenging procedure. A total laparoscopic approach to the left colectomy is an interesting option for critically ill patients although reports in the literature on this subject are scarce and its approach still not standardized because of its selective nature for indication. There are several advantages associated with conduction of totally laparoscopic approach to the left colon. Intracorporeal vessel sealing ensures an adequate lymph node dissection. Moreover, it enables the construction of a well-vascularized anastomosis. Ultimately, the occurrence of late wound complications are possibly reduced for the placement of a low abdominal incision exclusively used for specimen extraction. This paper aimed at describing our technique for a totally laparoscopic left colectomy for distal transverse and descending colon lesions.

Laparoscopic left colectomy with intracorporeal anastomosis: a complete mesocolic excision with preservation of the inferior mesenteric vein – a video vignette

“…This type of preservation of the vein may offer the possibility of a higher anastomosis in the descending colon avoiding late anastomotic leaks because of the venous drainage preservation [1]. Also, this dissection may avoid nerve damage compared to traditional ligation and dissection close to the origin of the inferior mesenteric artery and vein [2]. This video shows a feasible minimally invasive approach preserving the IMV in the left colectomy.…”