Combining All Forces – APR in Obese Male

Jill Motl, MD, George Melich, MD, Tareq Kamal, MD, Ajit Pai, John Park, MD, Leela Prasad, Slawomir Marecik, MD. Lutheran General Hospital

Cylindrical abdominoperineal resection poses great technical difficulties, especially in the case involving a narrow male pelvis in an obese patient. This video features our strategies to perform an efficient, yet oncologically sound resection in such a patient. Some of these strategies involve initial hand assisted laparoscopic colonic mobilization, robotic cylindrical pelvic dissection, perineal dissection in prone position, coccygectomy, and an air insufflation strategy to deliver the specimen.

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