da Vinci Robot Assisted Right Hemicolectomy with Intracorporeal Anastamosis

Video Type: CVideo
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Author: Christina Cheng
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

This procedure is a da Vinci Robot assisted Right hemicolectomy with intracorporeal anastomosis performed on a 52 year-old male who was found to have a cecal adenocarcinoma on screening colonoscopy. Metastatic work-up was negative.

DOI:http://dx.doi.org/10.17797/gb6xh7cx7u

Editor Recruited by: Vincent Obias

Advanced

Procedure

da Vinci robotic assisted right hemicolectomy

Indications

Adenocarcinoma of the cecum or right colon

Contraindications

Patients with history of prior abdominal surgeries and with significant adhesions; Patients requiring emergency surgery, patients who cannot tolerate insufflation or prolonged operative times.

Instrumentation

Setup

Preoperative subcutaneous heparin and oral Entereg 12mg The patient is laid supine with both arms tucked.

Preoperative Workup

CT chest/abdomen/pelvis to look for metastatic disease. Preoperative medical and cardiac risk stratification.

Anatomy and Landmarks

A periumbilical incision is made for the camera port, the abdomen is entered with the open Hasson technique. A robotic trocar is inserted and insufflation is induced to 15mmHg. Three additional 8mm trocars are placed �¢ï¿½ï¿½ left upper quadrant, left mid-abdomen, and right lower quadrant. A 5mm assist port is placed in the left lateral abdomen at the level of the umbilicus. The da Vinci robot is then docked.

Advantages/Disadvantages

The advantages of robotic-assisted low anterior resection are a minimally invasive approach with 3D high-definition visuals, camera stability, and the dexterity of wristed instruments for dissection. Disadvantages include longer operation and anesthesia time.

Complications/Risks

Risk of ureteral injury, difficulty with controlling significant bleeding.

Disclosure of Conflicts

Risk of ureteral injury, difficulty with controlling significant bleeding.

Acknowledgements

References

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