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Surgical techniques for advanced transverse colon cancer using the pincer approach of the transverse mesocolon

Abstract

Background

Laparoscopic surgery for colorectal cancer, not only early cancer but also advanced cancer, has become standardized by some randomized controlled studies. However, cases involving advanced transverse colon cancer were excluded from these studies due to the technical difficulty of the surgery. Hence, laparoscopic surgery for advanced transverse colon cancer is still a theme that we need to overcome. To solve these issues, it is necessary to establish a standardized approach and surgical technique.

Surgical techniques

The advantage of our method, which approaches from both sides of the transverse mesocolon, is that it is easier to achieve hemostasis when active bleeding occurs because this approach provides space for ligating and sealing. This allows the surgeon to perform lymphadenectomy around the superior mesenteric artery and vein.

Conclusions

We introduced the usefulness of the “Pincer approach of the transverse mesocolon” to standardize laparoscopic surgery for advanced transverse colon cancer.

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Author information

HE participated in treatment of these patients, literature search, drafting the manuscript, making the video. IN participated in treatment of these patients and helped to do data analysis. MH helped to do data analysis. SM, MK, KT, HS, and SM participated in treatment of these patients. HO participated in treatment planning of these patients. All authors read and approved the final manuscript.

Correspondence to Hiroyuki Egi.

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Disclosures

Drs. Hiroyuki Egi, Ikki Nakashima, Minoru Hattori, Shoichiro Mukai, Masatoshi Kochi, Kazuhiro Taguchi, Haruki Sada, Yusuke Sumi, Hideki Ohdan have no conflicts of interest or financial ties to disclose.

Ethical standard

Patients were given written informed consent prior to surgery. This study was conducted in accordance with the Helsinki Declaration Guidelines with the approval of the Ethics Committee of Hiroshima University Hospital.

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Supplementary material 1 (MP4 263982 KB)

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Egi, H., Nakashima, I., Hattori, M. et al. Surgical techniques for advanced transverse colon cancer using the pincer approach of the transverse mesocolon. Surg Endosc 33, 639–643 (2019). https://doi.org/10.1007/s00464-018-6491-7

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Keywords

  • Laparoscopic surgery
  • Colon cancer
  • Transverse colon cancer
  • Pincer approach