Laparoscopic right colectomy from top to bottom

Could the top-down right hemicolectomy be an easier alternative to the classic medial-to-lateral approach in obese patients? A case report with video example

“…The top-to-bottom procedure is an unusual procedure used only in 4 % of cases. Levard [18] , in 2012, first described this technique to emphasize vascular variation and its approach, and other authors [19] described a hybrid medial approach in a top-to-down manner. This hybrid technique involves ligating the right mesenteric pedicle and right middle colic pedicle from above.…”

Robotic versus laparoscopic right hemicolectomy with complete mesocolic excision using a cranial approach: A propensity score-matched retrospective cohort study

“…However, the concept of using CME for right-sided colon cancer has emerged, and the retroperitoneal approach is useful due to the easy dissection along the embryological plane. The cranial approach was rst reported in 2012 [11] and has the potential to reduce the risk of intraoperative organ damage. A network meta-analysis comparing these three approaches concluded that each approach has advantages and disadvantages but failed to demonstrate the de nitive superiority of any approach [12] Some reports have described the usefulness of the medial-to-lateral and retroperitoneal approaches for right-sided colectomy using robotic surgery [13][14][15][16][17]; however, few reports have demonstrated the usefulness of robotic CME (R-CME) with the cranial approach [18,19].…”