Wanda Petz, MD, Emilio Bertani, MD, Simona Borin, MD, Alessandra Piccioli, Uberto Fumagalli Romario, Giuseppe Spinoglio, MD, FACS. European Institute of Oncology
Background: Single-center non randomized series have shown that D3 lymphadenectomy and complete mesocolic excision (CME) in the surgical treatment of colon cancer can provide better oncologic results in comparison with conventional technique in which integrity of mesocolon is not preserved and central lymph nodes are not removed.
However, this technique is technically demanding, particularly with a laparoscopic approach.
Aim of this study is to describe a robotic suprapubic approach to right colectomy with CME and D3 lymphadenectomy and to report oncologic safety and short term outcomes.
Methods: Data from 57 consecutive patients who received a robotic right colectomy with suprapubic approach for right colon cancer are presented.
Surgery is realized with the Da Vinci Xi® system and all trocars are placed along a horizontal line 3-6 cm above the pubis. CME with fluorescence-guided D3 lymphadenectomy is performed.
After Indocyanine Green intravenous injection, bowel stumps perfusion is assessed, and an intracorporeal isoperistaltic side-to-side mechanical anastomosis with robotic linear stapler and manual closure of insertion holes is realized.
The specimen is extracted through a Pfannenstiel incision.
Results: Patients median age was 69 years, median body mass index was 27 kg/m2. Median operative time was 228 minutes, blood loss was negligible, no conversions to open or laparoscopic surgery occurred. Median hospital stay was six days; two postoperative grade IIIa Clavien-Dindo complications occurred, no 30-days postoperative death was registered. Resection margins were negative in all patients; median tumour diameter was 3.6 cm, median specimen length was 40 cm, median number of harvested lymph nodes was 37.
Conclusions: Robotic right colectomy with cme using a suprapubic approach is a feasible and safe technique that allows for an extended lymphadenectomy and provides high quality surgical specimens.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95434
Program Number: P299
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster