RIGHT HEMICOLECTOMY WITH D3 LYMPHADENECTOMY: DEMONSTRATION OF THE TECHNIQUE IN LAPAROSCOPIC ONCOLOGICAL SURGERY

Introduction The increasing incidence of colon cancer, particularly diagnosed in elderly patients, intensifies the debate over surgical treatments. Right hemicolectomy with D3 lymphadenectomy performed laparoscopically is a safe option with excellent oncological outcomes for patients.

Objective The goal of this video is to demonstrate the details of the technique used for the resection of a cancer in the ascending colon through right hemicolectomy with D3 lymphadenectomy via laparoscopy.

Case Presentation A 79-year-old male patient with hypertension and diabetes presented with asthenia and weakness. Laboratory tests confirmed anemia, and colonoscopy revealed a lesion in the right colon. No secondary lesions were detected on staging via CT scan. The decision was made to perform right hemicolectomy with D3 lymphadenectomy laparoscopically, which allows for the dissection of lymph nodes from the origin to the terminal branch of the main artery supplying the tumor. The pathological analysis of the resected segment revealed tubular adenocarcinoma with pT3pN0 staging and no neoplastic involvement in the lymph nodes (0 out of 32 lymph nodes). The patient progressed well postoperatively, with no complications, and was discharged on the 6th day.

Discussion D3 lymphadenectomy in right hemicolectomy for tumors of the ascending colon is a technically challenging procedure that requires detailed knowledge of surgical anatomy and careful dissection. With studies already suggesting its oncological importance, it is vital to study its steps to familiarize colorectal surgeons with this approach.

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Artikel online veröffentlicht:
25. April 2025