Medial vs. inferior approach in laparoscopic right hemicolectomy: a comparative study of the perioperative outcomes for early-career surgeons.

PURPOSE: To compare the safety of the medial and inferior approaches in laparoscopic right hemicolectomy and assess their suitability for early career surgeons.

METHODS

In this multicenter cohort study, 289 patients who underwent laparoscopic right hemicolectomy at 21 institutions were analyzed using propensity score matching. The outcomes of the medial and inferior approaches were compared in the overall cohort and in cases performed by early career surgeons (≤ 12 postgraduate years).

RESULTS

In the overall cohort (medial, n = 119; inferior, n = 170), no significant differences were observed in the intraoperative or postoperative complication rates, operative time, or blood loss. Among early career surgeons (medial, n = 42; inferior, n = 99), the medial approach was associated with a lower incidence of postoperative complications (OR 0.25; 95% CI 0.04 to 0.93; p = 0.037) and a shorter operative time (β = -21.75 min, 95% CI -40.57 to -0.94; p = 0.040).

CONCLUSION

For early career surgeons, the medial approach was associated with a lower risk of postoperative complications and a shorter operative time. These findings support the educational value of this technique and suggest that prioritizing it in early surgical training may enhance perioperative safety and inform surgical training curricula.