Lymphadenectomy along the middle colic artery in laparoscopic resection of transverse colon.

ABSTRACT

BACKGROUND/AIMS: Although laparoscopic-assisted colectomy has been replacing open colectomy, dissection of lymph nodes along the main artery is sometimes difficult and dangerous in laparoscopic-assisted colectomy, especially, lymph nodes at the origin of the middle colic artery in laparoscopic resection of the transverse colon. METHODOLOGY: After the isolation of colon, meso-colon in both ends was excised. Then, the colon was rotated clockwise 90 degrees by centering at the base of the meso-colon. This procedure made it easier to isolate the anterior and posterior leaf of the meso-colon at its base. The middle colic artery was divided at the root with the dissection of lymph nodes around the base of the meso-colon. RESULTS: Successful lymphadenectomy of the lymph node along the origin of the middle colic artery was performed. Twelve patients with early transverse colon cancer underwent laparoscopic transverse colon resection using this method. CONCLUSIONS: This method may contribute to the easy and safe laparoscopic transverse colectomy by improving the limited view of the laparoscope and raises the possibility for laparoscopic resection of advanced colon cancer.