Laparoscopic Right Hemicolectomy – Anatomy and Critical Structures
Samir Delibegovic

Laparoscopic Right hemicolectomy is a procedure that involves removing the cecum, the ascending colon, the hepatic flexure, the first third of the transverse colon, and part of the terminal ileum. Due to anatomic complexity, laparoscopic surgery for right colon cancer, especially hepatic flexure and transverse colon, is not an easy procedure. Some key steps are quite complicated procedures, so we would like to point out and explain the difficult sites of dissection during a right colectomy.

Keywords: laparoscopic, right hemicolectomy, mesenteric attachments

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1. Adamina M, Manwaring ML, Park KJ, Delaney CP. Laparoscopic complete mesocolic excision for right colon cancer. Surg Endosc. 2012;26:2976-80. doi: 10.1007/s00464-012-2294-4.
2. Sehgal R, Coffey JC. Historical development of mesenteric anatomy provides a universally applicable anatomic paradigm for complete/total mesocolic excision. Gastroenterol Rep. 2014;2:245-50.
3. Coffey JC, O’Leary DP. The mesentery: structure, function, and role in disease. Lancet Gastroenterol Hepatol. 2016;1:238-47.
4. Culligan K, Walsh S, Dunne C, et al. The mesocolon: a histological and electron microscopic characterization of the mesenteric attachment of the colon prior to and after surgical mobilization. Ann Surg. 2014; 260:1048-56.
5. Coffey JC, Culligan K, Walsh LG, et al. Anappraisal of the computed axial tomographic appearance of the human mesentery based on mesenteric contiguity from the duodenojejunal flexure to the mesorectal level. Eur Radiol. 2016;26:714-21.
6. Coffey JC, Dillon M, Sehgal R, Dockery P, Quondamatteo F, Walsh D, Walsh L. Mesenteric-Based Surgery Exploits Gastrointestinal, Peritoneal, Mesenteric and Fascial Continuity from Duodenojejunal Flexure to the Anorectal Junction – A Review. Dig Surg. 2015;32:291-300
7. Strey CW, Wullstein C, Adamina M, Agha A, Aselmann H, Becker T, Grützmann R, Kneist W,
Maak M, Mann B, Moesta KT, Runkel N, Schafmayer C, Türler A, Wedel T, Benz S. Laparoscopic right hemocolectomy with CME: standardization using the critical view concept. Surg Endosc. 2018;32:5021-5030. doi: 10.1007/s00464-018-6267-0.
8. Alsabilah J, Ki WR, Kim NK. Vascular structures of the right colon: incidence and variations with their clinical implications. Scandinavian Journal of Surgery. 2017; 106:107-115.
9. Spasojevic M, Stimec BV, Fasel JF, Terraz S, Ignjatovic D. 3D relations between right colon arteries and the superior mesenteric vein: a preliminary study with multidetector computed tomography. Surg Endosc. 2011;25:1883-1886. DOI 10.1007/s00464-010-1480-5.
10. Netter Fh. Atlas of human anatomy. 4 th edition. Philadelhia; Saunders: 2006.
11. T Ogino T, Takemasa I, Horitsugi G, Furuyashiki M, Ohta K, Uemura M, Nishimura J, Hata T, Mizushima T, Yamamoto H, Doki Y, Mori M. Preoperative Evaluation of Venous Anatomy in Laparoscopic Complete Mesocolic Excision for Right Colon Cancer. Ann Surg Oncol. 2014;21:S429-S435. DOI 10.1245/s10434-014-3572-2 .