This suture was passed through the mesentery close to the ileocecal valve, and it was fixed under to the tissue with clips to avoid the suture to slide through the fatty tissue, which allows moving the colon from one side to another by pulling from each side of the suture. This suture allowed the right exposition of the colon during the different phases of the surgery by pulling of the two ends of the suture. Once the main vessels have been divided and the resections of the transverse colon and ileum have been done, a side-to-side intracorporeal anastomosis is performed using a 60mm Endo Stapler with blue cartridge (Figure 1). The orifice of the anastomosis was closed with a running suture by using the Endo Stitch (Figure 2).

The specimen was removed from the abdominal cavity in a 15mm bag through the same umbilical incision, which was closed with a running absorbable suture under a proper direct vision. Figure 1 Intracorporeal anastomosis using an Endo Stapler with a blue cartridge. Figure 2 Total intracorporeal anastomosis performed. 3. Results Twenty-two patients were males (57,9%) and 16 females (42,1%), with an average age of 68,39 years old (range 45�C84). Previous clinical history of the patients revealed that 12 of them had previous abdominal surgery. Mean ASA score was 2,71, and the average BMI was 27,88 (range 19,81�C41,5). Lesions were located preoperatively in the cecum in 15 cases (39,5%), in ascending colon in 8 (21,1%), in hepatic flexure in 12 (31,5%), and in transverse colon in 3 (7,9%).

Most lesions were adenocarcinoma (25 cases, 65,8%), while the remaining were polyps (12 cases, 31,5%), and one case was due to a previous mucocele of the appendix. Dacomitinib Only 17 of these lesions (44,7%) could be detected by the CT scan, while the remaining ones were very small and could not be identified by this imaging technique. All patients were operated following the same technique, although in 5 of them it was necessary to perform an adhesiolysis due to previous surgery. An extended right hemicolectomy was performed in 17 cases (44,7%), including the transverse colon left to the round ligament, while in the rest of the cases the technique was a standard right colonic resection. Regarding the incision, a periumbilical incision was performed in our initial 14 cases (36,8%), while the rest of the cases a transumbilical incision was used (Figure 3). Patient satisfaction increases with the changes in the way that the incision was performed, due to better cosmetic results obtained. Medium size of the incision was 3,25cm (range 2,5�C5,2). Figure 3 Transumbilical incision one month after surgery. Mean surgical time was 117,42 minutes (range 75�C190), while the average blood loss during surgery was 118,48cc.