Abdul Razaque Shaikh, Syed Asad Ali, Mujeeb Rehman Abbasi.
Laparoscopic Assisted Right Colectomy: Early Experience.
Ann Pak Inst Med Sci Nov ;13(2):199-202.
Objective: To access safety & feasibility of laparoscopic-assisted right hemicolectomy as a logical progression towards advanced laparoscopic colorectal surgery. Place and Duration: This study was conducted at Minimal Invasive Surgical Centre LUMHS Jamshoro & Private hospitals from Aug 2012 to July 2015. Methodology: A prospective analysis of 57 patients undergoing laparoscopic right hemicolectomy was done. All cases were diagnosed and operability was assessed according to our hospital protocol. Access was gained using supra-umbilical open Hasson technique. Right hemicolectomy was performed in standard fashion using lateral to medial dissection. Extra corporeal anastomosis was performed by extending supra-umbilical port incision to 5-6cm. Results: Total number of cases were 57. Mean age of the patients was 32.70 (SDĀ±6.773) years with male to female ratio of 3:1. Out of 57 cases laparoscopic assisted right hemicolectomy was successfully performed in 53 cases. In 4 cases we switched to open procedure; due to bleeding, adhesion and locally advanced carcinoma. Mean operative time was110.77 minutes (95-160). Mean duration of return of bowel activity was 2.38 days (1.5-4). Mean hospital stay recorded was 6 days (4-10). Mean duration to return to normal physical activity was 21 days (15-30). On final histopathological diagnosis, there were 43(75.4%) cases of ileocecal tuberculosis, 9(15.8%) cases of carcinoma right colon and 5(8.8%) cases of carcinoma caecum. Surgery-related different postoperative complications were observed in 15 cases, however no mortality was observed in our study. Conclusion: Laparoscopic assisted right hemicolectomy is safe and feasible with smaller wound, shorter hospital stay, less analgesic requirement, early return of bowel and physical activity. This procedure can be used as a bridge in learning curve to master advanced laparoscopic colorectal surgery.
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