Laparoscopic Right Colectomy

Abstract

In the surgical technique for laparoscopic right colectomy (including ileocaecal resection), it is easy to understand the fascial composition based on the medial-retroperitoneal approach; thus, the surgical technique becomes evident. The anatomical landmarks of the medial-retroperitoneal approach in laparoscopic right colectomy are the third portion of the duodenum, the mesenteric root, and the caudal portion of the caecum. By lifting the mesenteric root of the terminal ileum ventrally, the dissection line from the duodenum to the caecum becomes apparent. When dissecting the mesentery, the dissection plane can be entered from the mesenteric root to the ventral side of the deep subperitoneal fascia. When the third portion of the duodenum is not apparent from the retroperitoneal field of view, lifting of the caecum ventrally and dissection of the ventral side of the deep subperitoneal fascia allow the identification of the duodenum. The medial-retroperitoneal approach is the preferred procedure in lymphadenectomy because it involves continued dissection of the ventral side of the deep subperitoneal fascia and the surface of the duodenum.