Counterclockwise colonic transposition after left extended colectomy: an efficient and reproducible alternative to the Deloyers procedure

Reconstruction of the digestive tract after extended left colectomy is a common challenge for colorectal surgeons. The main difficulty lies in lowering the colon into the pelvis to achieve a tension-free and well-vascularized anastomosis. We report our 10-year retrospective experience, in which a counterclockwise colonic transposition according to Lillehei and Wangensteen was performed in more than half of the cases. This technique differs from the more widely known Deloyers procedure solely by its axis of rotation. It offers the advantage of being more anatomical, easily reproducible, and functionally equivalent.