ASO Author Reflections: The New Continuous Certification Program and CME—What Is It, and How Can the Society of Surgical Oncologist Help with the New Requirements?

Facility Type is Another Factor in the Volume–Outcome Relationship for Complex Hepatopancreatobiliary Procedures

Combined Proctectomy and Hepatectomy for Metastatic Rectal Cancer: Safe for the Fit and Able—But for Everyone?

Dynamic Changes with Liver Atrophy as an Alternate Marker of Chemotherapy-Associated Liver Injury

The Oncoplastic Frenzy: Beware the Swing of the Pendulum

Using Center-Specific Medicare Data to Compare Cancer Care Outcomes: Are We Seeing the Whole Playing Field or Just a Blade of Grass

ASO Author Reflections: Preoperative Prediction of Postmastectomy Radiation Therapy After Neoadjuvant Systemic Therapy

Robotic Extended Right Hemicolectomy with Complete Mesocolic Excision and D3 Lymph Node Dissection Abstract Background Recent studies have shown the benefits of complete mesocolic excision and extended lymphadenectomy (D3 lymph node dissection) in patients with colon cancer.1–3 Methods We present the case of a 62-year-old male with hepatic flexure adenocarcinoma. No metastatic disease was identified by computed tomography. A robot-assisted extended right hemicolectomy with complete mesocolic excision, D3 lymph node dissection, and resection of the mesentery with intact visceral peritoneum was performed. Results The trocars are placed in the right lower (8 mm), lower midline (8 mm), and left upper (12 mm) quadrants. The camera port is placed superior to the umbilicus, and the assistant port is placed in the left lower quadrant. The robotic right lower port is used to place the cecum on tension in order to outline the ileocolic pedicle. The assistant retracts the transverse colon cephalad to outline the superior mesenteric artery and vein. Using two robotic arms, the surgeon begins dissection over the superior mesenteric vein inferior to the ileocolic pedicle. Cephalad dissection along the superior mesenteric vein proceeds with reflection of the mesentery and D3 lymph nodes laterally to allow en bloc resection. The ileocolic and middle colic vessels are identified, ligated and divided at their origins. The plane is then developed between the right colon mesentery and the retroperitoneum, including Gerota’s fascia, duodenum, and head of the pancreas, in a medial-to-lateral fashion, with care taken to ensure an intact visceral peritoneum is maintained. The proximal transverse colon, hepatic flexure, and ascending colon are mobilized by taking down lateral attachments. The intervening mesentery is transected, and perfusion is assessed with indocyanine green fluorescence imaging. An intracorporeal, isoperistaltic, side-to-side anastomosis is performed using the 45-mm robotic stapler. The common enterotomy is sewn closed in two layers. Pathology showed T3N0 adenocarcinoma with all negative margins. Conclusion Extended right hemicolectomy with complete mesocolic excision and D3 lymph node dissection is facilitated by a robotic approach, which improves visualization and instrument dexterity.

Setting the Stage for Esophageal Cancer: Bulk versus Breadth

ASO Author Reflections: Hepatectomy and Proctectomy for Metastatic Rectal Cancer: Is a Combined Approach Best for All Patients?