Laparoscopic colectomy is feasible in the mega-obese patient using a standardized technique.

The use of laparoscopic colectomy in morbidly obese individuals is controversial. There are significant safety issues including increased risk of bleeding, increased anastomotic leak and high operative conversion rates. We report the first successful laparoscopic colectomy in a patient with the most extreme category of morbid obesity, mega-obesity (body mass index [BMI]>70). We describe a standardized technique using a completely intracorporeal technique with all resection lines reinforced with a bioabsorbable staple line reinforcement material. This technique has the potential of making laparoscopic colectomy more feasible for patients with morbid obesity in general.