Robert K Cleary, MD, Yu-Hsin Lin, MD
St Joseph Mercy Hospital Ann Arbor
Objective: The purpose of this study was to determine the effectiveness of the Vessel Sealer when performing robotic colorectal operations.
Methods and Procedures: The Vessel Sealer in this video was utilized by the surgeon through the robotic dissecting port (D1) during a robotic sigmoid resection for diverticulitis.
Conclusion: The implementation of robotics for colorectal operations provides the advantages of 3D imaging, the ability of the surgeon to use a third arm for fixed retraction, and a stable camera platform under surgeon control. Most colorectal operations mandate the availability of an energy source to effectively provide hemostasis when dissecting and dividing pertinent arteries, veins, and vascular mesentery. Until now, this has been accomplished by way of an assistant through an assistant port or the console surgeon with an instrument lacking articulation. The new Vessel Sealer provides several advantages over similar instruments to date: 1) It is controlled by the surgeon at the surgeon console; 2) It provides complete hemostasis when coagulating and dividing vessels up to 7mm in diameter; 3) It is controlled with console-based wristed movements and articulation that provide the surgeon strategic angles which allow more effective dissection, limiting blood loss and decreasing operative time; 4) The satisfying audio feedback provided by the system allows for coagulation and cutting to become "second nature" to the surgeon; 5) It allows minimally invasive dissection of complicated tissue planes (phlegmonous diverticular disease adherent to pelvic sidewall) thereby potentially decreasing the need for conversion. The Vessel Sealer is a significant advance in robotic surgical systems, allowing effective coagulation and division of vascular arcades, and effective dissection of tissue planes during robotic colorectal operations.
Session: Video ChannelDay 3
Program Number: V118