da Vinci Assisted Low Anterior Resection and Colovesical Fistula Repair

Video Type: CVideo
  • 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
  • Clearly annotated and narration is a must in these videos
  • These have clear but concise abstracts are not able to be indexed in PubMed
  • Distributed in newsletters, featured on our website and social media
  • Peer reviewed

Author: June Hsu
Published:
Specialties: General Surgery, Robotic Surgery
Schools: Rutgers- Robert Wood Johnson Medical School
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Basic Info

Contributors: Jimmy Lin and Craig Rezac

Robotic surgery offers benefits to both patient and surgeon by allowing smaller incisions and faster recovery time, to better accuracy, flexibility and control.  Many procedures which had previously been conducted with laparoscopy, or open surgery, are becoming further improved upon in robotic surgery. This video demonstrates two such procedures, from different specialities, being performed; the low anterior resection and colovesical fistula repair.

DOI#: http://dx.doi.org/10.17797/f1frvag53q

Advanced

Procedure

Robot-Assisted Low Anterior Resection and Colovesical Fistula Repair

Indications

Complicated diverticulitis, carcinoma of the rectosigmoid colon higher than 5cm from the anal verge.

Contraindications

Diseased colon less than 5cm from the anal verge, unstable patients, large phlegmonous mass, obstruction, perforation or ileus leading to massive bowel distension and loss of domain, carcinomatosis, morbid obesity (relative), multiple previous abdominal surgical procedures (relative), extensive abdominal adhesions (relative)

Instrumentation

Setup

Patient is placed in the supine position with both arms tucked. The robot is docked on the patient's right shoulder

Preoperative Workup

CT scan, colonoscopy, cystoscopy

Anatomy and Landmarks

Bladder, ureters, white line of Toldt, inferior mesenteric vessels, splenic flexure

Advantages/Disadvantages

Advantages: Superior retraction, visualization and dissection
Disadvantage: longer procedure/anesthesia time, potentially more cost

Complications/Risks

Injury to the ureters, spleen, anastomotic leak, bladder leak, blood loss, infection

Disclosure of Conflicts

No conflicts to disclose

Acknowledgements

References

Courtney M. Townsend, Jr., MD; R. Daniel Beauchamp, MD; B. Mark Evers, MD; and Kenneth L. Mattox, MD, 2012, Sabiston Textbook of Surgery, 19th Edition. Suanders

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