title: The transverse colon cancer with the reversed rotation of the midgut treated with single incision laparoscopic colectomy.
abstract: BACKGROUND
  Reversed rotation of the midgut is a rare type of intestinal malrotation. Moreover, synchronous colon cancer has rarely been reported. Preliminary experience with single-incision laparoscopic colectomy (SILC) for colon cancer with reversed rotation of the midgut is reported.
  
  
  METHODS
  An 82-year-old woman was admitted because of a fecal occult blood. A colonoscopy revealed transverse colon cancer. An air-barium contrast enema showed the right-sided sigmoid colon and the left-sided cecum. A computed tomography revealed that the duodenum and the transverse colon were situated at the ventral side of the superior mesenteric artery, and a preoperative diagnosis of suspicion of reversed rotation of the midgut was made.
  
  
  METHODS
  First, a lap protector was inserted through a 4.0 cm transumbilical incision. Four 5 mm ports were placed in the lap protector. On the observation of laparoscopy, the cecum and the ascending colon were not fixed with the retroperitoneum and situated on the left, and the sigmoid colon was situated on the right. We successfully mobilized the transverse colon using a single-incision laparoscopic approach. Resection was achieved following extracorporealization, and the anastomosis was performed extracorporeally using staplers. The patient was discharged on the thirteenth postoperative day. Postoperative follow-up did not reveal any umbilical wound complications.
  
  
  CONCLUSIONS
  SILC for colon cancer associated with malrotation of the midgut is feasible and a promising alternative method because of its less invasiveness and its adaptability to the malrotation without extending the skin incision.
authors.affiliation: Department of Surgery, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, 910-8526 Japan.
authors.forename: Yasumitsu
authors.initials: Y
authors.lastname: Hirano
authors.affiliation: Department of Surgery, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, 910-8526 Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Hattori
authors.affiliation: Department of Surgery, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, 910-8526 Japan.
authors.forename: Manami
authors.initials: M
authors.lastname: Fujita
authors.affiliation: Department of Surgery, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, 910-8526 Japan.
authors.forename: Youji
authors.initials: Y
authors.lastname: Nishida
authors.affiliation: Department of Surgery, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, 910-8526 Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Douden
authors.affiliation: Department of Surgery, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, 910-8526 Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hashizume
keywords: Laparoscopic colectomy; Malrotation of the midgut; Reversed rotation; Single incision laparoscopic colectomy