The dilemmas of the transverse colon cancer: segmental or extended right colectomy, laparoscopic hazards for the inexperienced surgeon

The benefits, efficacy, and safety of laparoscopic surgery for colon and rectal surgery have been previously demonstrated. However, patients with transverse colon cancer were not included in most of the landmark studies. Several reasons have been described for this. Its relatively low frequency and the complexity of performing an adequate laparoscopic lymphadenectomy in the area of the middle colic vessels are among the main reasons. Performing the high ligation of the middle colic vessels is possibly the most challenging and complex step of a laparoscopic transverse colon resection. The proximity of the middle colic vessels to the superior mesenteric artery and vein contribute to the complexity of this step from a technical standpoint, making it challenging for inexperienced surgeons. From a surgical standpoint, transverse colon lesions can be treated by means of a laparoscopic extended right colectomy, a segmental transverse colectomy or a left colectomy.