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Robotic total abdominal colectomy with ileorectal anastomosis

William Steinhardt, MD, Ty A Bowman, MS, Heidi Lentz, MS, Henry J Lujan, MD, FACS, FASCRS. Jackson South Community Hospital

This video demonstrates a robotic total abdominal colectomy with ileorectal anastomosis. The indication for the procedure was attenuated familial adenomatous polyposis in a 75-year-old male. Port placement is shown and the reasoning for the orientation and operative approach are discussed. 4 robotic and 2 assistant ports are used to complete the procedure. The video describes a counter clockwise dissection approach. Identification of the distal margin, mobilization, identification of the ureter, devascularization and transection near the rectosigmoid junction are shown. Timing of docking, undocking, and redocking the robot with table repositioning are discussed. Approach to the splenic and hepatic flexures is demonstrated. The right lower quadrant incision used for the robotic stapler port is extended to 5 cm for specimen extraction. Intracorporeal anastomosis is performed with a 25 circular stapler and reinforced with a 3.0 barbed suture using the robot. Operative time was 312 minutes. The patient was discharged on postoperative day 2 and was doing well without complications at 6 months follow up.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 93690

Program Number: V306

Presentation Session: Video Loop Day 3

Presentation Type: VideoLoop

503

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