Robotic-assisted Low Anterior Resection with Proximal Colotomy

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:
1 vote, average: 5.00 out of 51 vote, average: 5.00 out of 51 vote, average: 5.00 out of 51 vote, average: 5.00 out of 51 vote, average: 5.00 out of 5 (1 votes, average: 5.00 out of 5)
You need to be a registered member to rate this post.
Loading...
Basic Info

Contributors: Dr. Jimmy Lin and Dr. Craig Rezac

Robotic surgery offers benefits to both patient and surgeon by allowing smaller incisions with faster recovery time, as well as better accuracy, flexibility and control.  Many procedures which had previously been conducted with laparoscopy, or open surgery, are further improved upon with robotic surgery. This is a video of a robotic-assisted LAR in a male with a T4N2M0 rectal cancer with concern for invasion into the prostate and seminal vesicles. The patient also has a synchronous proximal tubulovillous adenoma which had been biopsied but not completely resected during a previous colonoscopy. He therefore also underwent an intra-operative colotomy and colon polyp resection. This video demonstrates the advantages of robotic-assisted surgery in conjunction with more traditional procedures in order to provide the best care possible for the patient.

Advanced

Procedure

Robotic-assisted Low Anterior Resection for Rectal Cancer and Colotomy with Resection of Synchronous Colon Polyp

Indications

Carcinoma of the rectosigmoid colon with synchronous proximal colon polyp

Contraindications

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, MRI, trans-rectal ultrasound

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. Saunders

Share
0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply