We aimed to demonstrate a novel combination approach of cranial and caudal-dorsal on laparoscopic right hemicolectomy (LRH) for a patient diagnosed with right colon carcinoma.

We performed a LRH with a combination approach of cranial and caudal-dorsal. First, we started the operation from the distal root of the small intestine mesentery and the backside of the ascending colon. The plane between the Gerota and Toldt fascias is opened, identifying duodenum and pancreas. Second, through the supramesocolic approach, gastrocolic ligament is opened and the gastrocolic trunk of Henle (GTH) and its branches are identified, then the superior right colic vein can be divided. Third, from the middle approach, the ileocolic vessels, right colic vessels, middle colic vessels right branches are divided. The fourth, after completing the colon mobilization and transecting the mesentery of both ileum and transverse colon, an intracorporeal isoperistaltic side-to-side ileo-colic anastomosis is performed using a linear stapler.

The operation lasted approximately 150 min, with an intraoperative blood loss of only 30 ml. Postoperative pathology showed pT1N0M0 (15 lymph nodes resected, all negative for metastasis). The patient was discharged on postoperative day 7 without complications.

The novel combination approach of cranial and caudal-dorsal on LRH represents a novel surgical method, and we believe it offers several advantages over traditional approaches.