15th International Congress of the European Association for Endoscopic Surgery (EAES) Athens, Greece, 4–7 July 2007

Object: In colorectal cancer with liver metastasis, the only way that perfact cure is complete liver resection. Simultaneous liver and colon resection is relatedwith extent of colon surgery, volume of liver resection, patients condition, and bleeding. Laparoscopic simultaneous colon and liver resection demands advanced technical skills, optimal location of port, patient selection, and cooperation of operation team. In laparoscopic liver resection, thehandport provides palpationof liver, liver retraction, and compression of bleeding site. We demonstrate laparoscopic extended right hemicolectomy with left lateral segmentectomy of liver. Method: 28 years old male patient who suffers from transverse colon cancer with liver metastasis is admitted our institution. First of all, the operation is started with extended right hemicolectomy. Ileocolic and midcolic vessels is ligated and divided respectively. Medial to lateral dissection is proceeded. After complete dissection of right and transverse colon, handport is established in upper abdomen. Through handport colon is delivered and cut by linear cutter. By using the endosono metastatic cancer is localized. The falciform and coronary ligament is dissected by monopolar scissor and harmonic scalpel. Liver parachyme dissecrtion is commenced by ligasure. Through the handport liver is palpated and retracted by left hand. Portal veins and small ducts are coagulated by ligasure. Left hepatic vein and duct is ligated and divided by endocutter. The specimen is retrieved and ileocolic side to side anastomosis is conducted by way of handport. Result: The operation time is 345 minutes, amount of bleeding is 120 cc. There is no conversion to conventional open method. Without any complications, patient discharged postoperative 9th days. Conclusion: We did laparosopic simultaneous liver and colon resection safely and effectively. In the liver parenchyme dissection, the ligasure is used effectively without any bile leakage and bleeding. V002 Intestinal, Colorectal and Anal Disorders