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

Surg Endosc. 2019 Feb;33(2):639-643. doi: 10.1007/s00464-018-6491-7. Epub 2018 Oct 23.

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.

Keywords: Colon cancer; Laparoscopic surgery; Pincer approach; Transverse colon cancer.

MeSH terms

  • Colectomy* / adverse effects
  • Colectomy* / methods
  • Colon, Transverse* / pathology
  • Colon, Transverse* / surgery
  • Colonic Neoplasms* / pathology
  • Colonic Neoplasms* / surgery
  • Female
  • Humans
  • Japan
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Lymph Node Excision / methods*
  • Male
  • Mesocolon / surgery*
  • Middle Aged
  • Neoplasm Staging
  • Treatment Outcome