• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Laparoscopic complete mesocolic excision conducted by combining medial and cranial approaches for transvers colon cancer

Shinichiro Mori, Yoshiaki Kita, Kenji Baba, Masayuki Yanagi, Yusuke Tsuruta, Takako Tanaka, Yuko Mataki, Kosei Maemura, Yasuto Uchikado, Shoji Natsugoe. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima

Objective: We have evaluated the safety and feasibility of laparoscopic complete mesocolic excision (CME) conducted by combining medial and cranial (MC) approaches with lymph node dissection around the gastrocolic trunk (GCT) and the middle colic vessels for transvers colon cancer.

Patients and Methods: We retrospectively analyzed 18 consecutive patients with transverse colon cancer who had undergone laparoscopic complete mesocolic excision (CME) via combined medial and cranial (MC) approaches between July 2009 and June 2015 by studying video recordings of the procedure and assessing operative data, pathological findings, length of bowel resected, complications, and length of hospital stay.

Surgical procedure: The medial approach was performed by dissecting the peritoneum behind the the ileocolic vessels and separating between mesocolon and fusion fascia. The ileocolic vessels were then divided at their roots. Lymph node dissection proceeded along the SMV to expose the middle colic artery (MCA) and its branches. The MCA was identified arising from the SMA and these vessels were severed at the roots of their branches. Subsequently, the GCT and its branches were carefully and sufficiently exposed from the medial side. A wide separation of embryological tissue plane between the pancreatic head and transverse mesocolon was performed, and then the separation of the mesofascial plane was also performed. In patients with left transverse colon cancer, dissection of the peritoneum behind the inferior mesenteric vein was followed by performing mesofascial separation between the descending mesocolon and fusion fascia, and mobilizing the splenic flexure.

Next, a cranial approach was performed by dissecting the greater omentum, after which the fusion fascia between the omentum and transverse mesocolon was detached, exposing the SMV, and the hepatic flexure was mobilized in continuity. The accessory middle colic veins were carefully dissected with 3dimensional identification of the GCT via both of the MC approaches.

Results: Sixteen and two patients graded mesocolic and intra-mesocolic plane, respectively. Nine, two, four, and three patients had T1, T2, T3, and T4a tumors, respectively. The median number of lymph nodes retrieved was 17.2, no lymph node metastasis being identified. The mean length of large bowel resected was 23.3 cm. The mean operative time and intraoperative blood loss were 272 min and 41 mL, respectively. No intraoperative complications occurred in any patient. Two patients had postoperative complications. The median postoperative hospital stay was 15 days.

Conclusions: Laparoscopic CME via combined MC approaches is a safe and feasible procedure for transverse colon cancer.

53

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2016 abstract archive

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
sagesweb@sages.org
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons