Laparoscopic Radical Transverse Colon Cancer Resection with Transvaginal Specimen Extraction

Abstract

Transverse colectomy can be selected for female patients with transverse colon cancer who undergo laparoscopic radical transverse colon cancer resection with transvaginal specimen extraction. The operating characteristics of this technique are as follows: According to the location of the tumor, hepatic flexure or splenic flexure dissociation, or even ileocecal dissociation, is required; no need to cut open the intestine in the abdominal cavity, which is more in-line with the requirements of aseptic surgery; stricter requirements for vaginal preoperative preparation; and transvaginal specimen extraction has broader indications due to the strong extensibility of the vagina, but is limited to female patients. The difficulty of this technique is mainly reflected in two aspects: First, it is the generality of key technologies of laparoscopic surgery, including correct identification of anatomical marks, reasonable surgical approach, complete mesenteric resection, mesenteric root vascular ligation, lymph node dissection, and exposure and protection of important tissues and organs. Another difficulty is reflected in the complete endoscopic gastrointestinal reconstruction unique to the NOSES operation, that is, the overlapping triangular anastomosis using the laparoscopic Endo-GIA, which is more difficult to reconstruct than other surgical methods. Therefore, the operation requires a stricter grasp of the indications, clear surgical thoughts, and exquisite operation skills. This chapter takes the case of the transverse colon cancer near the hepatic flexure which underwent the laparoscopic radical transverse colon cancer resection with transvaginal specimen extraction.