Laparoscopic complete mesocolic excision (CME) with completely medial approach for right-hemi colon cancer

Laparoscopic complete mesocolic excision (CME) has the potential to become the standard procedure of colon cancer surgery for its lower local recurrence rate and improved prognosis. Completely medial approach (CMA) is a promising access of laparoscopic CME in right hemicolectomy. A 45-year-old female patient was diagnosed as right-hemi colon cancer. Based on this case, we share the surgical strategies of laparoscopic CME with completely medial access combined with our previous study. Laparoscopic CME emphasized on en bloc resection of mesocolon without defections to the planes. Besides, further dissection is needed for cancer at the hepatic flexure, which involves subpyloric lymph nodes and of greater omentum that is within 15 cm of the tumor and along the greater curvature. The operation time was 128 min and the blood loss was 10 mL. The total number of central lymph nodes retrieved was 19. The time for passage of flatus and hospitalization were 2 and 12 days respectively. Laparoscopic CME with completely medial access is technically feasible, and should be conducted by experienced hand in right hemicolectomy.