Elevating surgical standards: The role of intraperitoneal isoperistaltic side-to-side anastomosis in colon cancer surgery.

Since its introduction in 1991, laparoscopic right colectomy has been the standard surgical treatment for benign and malignant right colon diseases. Extracorporeal anastomosis (ECA) is the most commonly used anastomotic technique. However, intracorporeal anastomosis (ICA) has emerged as a promising alternative because of its potential advantages. Recently, Wu et al provided compelling evidence supporting superiority of ICA over ECA, demonstrating reduced blood loss, smaller incisions, and faster postoperative recovery without increased complications. Despite these benefits, ICA presents certain challenges such as longer operative times and technical difficulties. However, advances in minimally invasive surgery, including robot-assisted platforms, may facilitate broader adoption of ICA by addressing the technical limitations. Furthermore, meticulous surgical techniques and perioperative infection control strategies are essential for mitigating intra-abdominal infectious complications. Given the increasing adoption of ICA in minimally invasive right hemicolectomy, further studies, including multicenter randomized controlled trials, are necessary to confirm its oncological safety and establish standardized surgical protocols. Overall, ICA has the potential to become the preferred anastomotic approach in both laparoscopic and robotic colorectal surgeries.