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To investigate if laparoscopic right colectomy has advantages when compared to a transverse incision.Patient who underwent a laparoscopic or an open right colectomy through a transverse incision in the VU University medical center or Zaans medical center from 2005 until 2009 wereprospectively followed.Patient groups were comparable in terms of age, gender, BMI and ASA classification. Laparoscopicprocedures were shorter (155 min vs 77 min, P < 0.001) with less blood loss (60 ml vs 130 ml, P = 0.001). Eight percent of patients in the laparoscopic group required a conversion. Hospital stay for the laparoscopic group was shorter (8 days vs 9 days, P = 0.04). Postoperative complications were comparable (28% vs 32%, P = 0.74). In both groups a radical resection rate of 96% was achieved (P = 0.94). At a median follow-up of 20 months the incidence of incisional hernias was similar. Overall survival at 60 months was 70% for the laparoscopic group and 67% for the transverse incision group (P = 0.84).Thepresent study may be the first in describing laparoscopy versus transeverse incision right colectomy. Postoperative complication rates and survival are comparable for both groups without clinically relevant differences. A randomized trial looking at non-inferiority of open right colectomy through a transverse incision is needed.