Laparoscopic right hemicolectomy

This chapter focuses on resection for cancer or suspected malignancy of the right colon. It outlines the surgical and anatomical principles pertaining to laparoscopic right hemicolectomy. The benefits of laparoscopic colorectal surgery have been demonstrated in randomised trials. Multidisciplinary team discussion is also mandatory for all patients with a diagnosis of colorectal cancer requiring right hemicolectomy. A pragmatic balance of risks and benefits for the patient should be considered in the context of the surgeon’s experience and laparoscopic skills. Patients suffering from severe or debilitating cardiopulmonary comorbidity have a relative contraindication for laparoscopic surgery due to their inability to tolerate pneumoperitoneum, extreme positioning, and prolonged anaesthesia that may be associated with laparoscopic surgery. A radical procedure requires that the tumour be removed with an adequate margin of normal colon together with the associated vascular pedicle with high vascular ligation. The gold standard approach for neoplasms of the right colon applies the principles of total mesorectal excision to colonic resection.