Laparoscopic radical right hemicolectomy with CME, CVL and division of right gastroepiploic vessels

This case report describes the laparoscopic technique of infrapyloric lymph node dissection as part of a complete mesocolic excision (CME) for right-sided colon cancer. While controversial and not routinely performed, this extended dissection is indicated in the presence of specific risk factors for nodal metastasis, such as elevated CEA (> 17 ng/ml) and obstructive symptoms, as presented in our 88-year-old patient. The article outlines the key surgical steps to safely clear the infrapyloric region, emphasizing ligation of the right gastroepiploic vessels and meticulous dissection to minimize bleeding and chyle leakage.