Laparoscopic left hemicolectomy with extracorporeal anastomosis surgical technique: how I do it

Abstract

First laparoscopic surgery was done in 1987. Since then, laparoscopic surgery is accepted as a revolution in surgical field. Now minimal invasive surgery is used almost in every surgical specialty. Although robotic surgery is evolving rapidly in the world, cost of robotic surgery is still not optimized. Laparoscopic colon resection is a well-established technique which has become the preferred surgical approach for most patients with colorectal disease. Benefits of laparoscopic colorectal surgery which include faster patient recovery, smaller incisions with better cosmesis, decrease in postoperative pain, early return of bowel function, and shorter hospital stay, and safety in colorectal cancer treatment with similar oncologic outcomes to open surgery have been published in many large series in the literature. Laparoscopic left hemicolectomy is now routinely performed at our center. Several techniques have been described for laparoscopic left hemicolectomy and they vary in terms of colon mobilization approach, blood vasculature control, anastomosis construction technique, and extraction site. In this article, we demonstrate how we are doing laparoscopic left hemicolectomy in a stepwise manner, illustrating key anatomical landmarks in a patient who presented with colon cancer. Our sincere hope is that this video material will provide invaluable information to surgical trainees and young surgeons early in their surgical careers.