Laparoscopic right hemicolectomy with intracorporeal anastomosis and natural orifice surgery extraction/minimal extraction site surgery in the obese

AbstractBackgroundDespite advantages associated with laparoscopic colorectal surgery, there is significant morbidity associated with incisions required for specimen extraction and restoration of bowel continuity. In laparoscopic colorectal surgery, the length of the longest incision depends upon that required to facilitate extra‐corporeal steps. The purpose of this study was to analyse obese patients (body mass index >30 kg/m2) who have undergone laparoscopic small bowel or right‐sided colonic resection with intracorporeal anastomosis (ICA) and natural orifice surgery extraction (NOSE)/minimal extraction site (MES) surgery.MethodsA retrospective review of 11 obese patients who have undergone laparoscopic small bowel and right‐sided colonic resection with ICA and NOSE/MES was conducted.ResultsMean body mass index was 40.4 kg/m2 (range 32.7–56 kg/m2) in 11 patients. Procedures performed were laparoscopic right hemicolectomy (7) – one with high anterior resection, pelvic peritonectomy, bilateral salpingo‐oophorectomy and greater omentectomy, small bowel resection (2), transverse colotomy (1) and segmental transverse colectomy (1). All colonic specimens were extracted via NOSE (vagi