Laparoscopic En Bloc Resection of Locally Advanced Colon Cancer With Involvement of the Liver, Small Bowel, Omentum, and Abdominal Wall

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BackgroundLocally advanced colon cancer with the involvement of adjacent organs is treated radically with en bloc resection with negative margins. Laparoscopy is seldom recommended for such patients.MethodsOperative laparoscopic technique is presented for radical en bloc resection of locally advanced right colon cancer.ResultsThe patient is a 56-year-old morbidly obese (body mass index 47) male, who was scheduled to undergo a routine laparoscopic right hemicolectomy and at exploration was found to have a large mass involving segments V and VI of the liver, small bowel, omentum, and abdominal wall. A laparoscopic-assisted en bloc resection was performed. The patient went home in 7 days. The tumor was staged as T4N0M0, American Joint Commission on Cancer stage IIb with 21 negative nodes.ConclusionsLaparoscopic resection for selected patients with locally advanced colonic neoplasms should be considered an option in tertiary referral centers.

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