Videos in Robotic Surgery

Laparoscopic robotic-assisted Heller procedure for esophageal achalasia

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This video demonstrates a robotic-assisted Heller procedure for treatment of esophageal achalasia. The surgeon starts by dissecting the gastroesophageal junction. The mobilization of the stomach is limited to the anterior and lateral aspect, leaving the posterior attachments intact. The myotomy is started just above the gastroesophageal junction and extended 6 cm proximally and 2 cm distally onto the stomach using robotic articulated scissors. The extension of the myotomy on the gastric side continues to be the most difficult part of the dissection. The change in direction of the muscular fibers, from circular at the esophagus, to oblique at the stomach, makes it difficult to develop the necessary submucosal plane for dividing the muscular fibers. The video demonstrates the freedom of movement of the articulated robotic instruments that allow the surgeon to divide each individual muscular fiber achieving a precise dissection of the gastroesophageal junction. Once the myotomy is completed a standard Dor Fundoplication is performed.

English - 12'15'' 00'27''  Trocar placement 00'35''  Robotic set-up 00'44''  Start of procedure 02'30''  Dissection of crura and esophagus 05'40''  Myotomy 08'30''  Dor fundoplication

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Robotic radical prostatectomy at the Vattikuti Urology Institute

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This video demonstrates how a robotic radical prostatectomy is performed at a high volume center in the United States of America. The authors have an extensive experience in robotic prostate surgery and describe the technique in detail.

English - 12'30'' 00'10''  Robotic set-up presentation 02'10''  Patient position 02'30''  Trocar placement 03'40''  Start of procedure 05'17''  3D simulation (1st step) 07'43''  3D simulation (2nd step) 10'35''  Suture of the urethra with the bladder 12'36''  End of procedure

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Robot-assisted Nissen-Rossetti fundoplication for the treatment of hiatal hernia

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This is a totally robotic Nissen fundoplication performed by an experienced laparosopic surgeon. It is detailed, commencing with robot set-up, which is done with the help of the scrubbed assistants. All the same steps of laparoscopic Nissen fundoplication are reproduced easily with robotic instruments.

English - 20'00'' 00'21''  Robotic set-up 00'50''  Start of procedure 01'18''  Dissection of crura 03'20''  Retraction of esophagus 04'30''  Hiatoplasty 06'46''  Fundoplication

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Robotic assisted esophagectomy

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This video presents in detail the robotic dissection of the oesophagus via a trans-thoracic approach. A mediastinal lymphadenectomy is also performed. Combined with a laparoscopic gastric mobilisation, a total minimally invasive approach to oesophagectomy is possible.

English - 11'00'' 01'07''  Characteristics of the procedure 03'07''  Parietal pleura 05'07''  Pretracheal lymph node dissection 08'47''  Mobilization of the esophagus 09'28''  End of the procedure

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Robotic-assisted low anterior resection with total mesorectal excision

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This video demonstrates a combined laparoscopic-robotic approach for resection of a low rectal cancer. Mobilization of the colon and mesenteric vascular division are performed laparoscopically. The Da Vinci robot is then utilized to complete the total mesorectal excision (TME). Finally, a laparoscopic stapled colo-anal anastomosis is performed.

English - 21'02'' 00'12''  Trocar placement 00'27''  Exploration 01'00''  Mobilization of splenic flexure 02'15''  Division of IMV 05'40''  Division of IMA 07'50''  Robotic set-up 08'35''  Right pelvic dissection 10'20''  Posterior pelvic dissection 11'40''  Left pelvic dissection 13'15''  Anterior pelvic dissection 15'00''  Reaching the pelvic floor 16'45''  Division of rectum 19'00''  Specimen extraction 19'45''  Colo-anal anastomosis 20'40''  Ileostomy creation

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Robotic assisted partial cystectomy for bladder endometriosis

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This video of robotic partial cystectomy demonstrates the superior dissecting and suturing ability of the DaVinci surgical robot. The partial cystectomy is performed with ease, after the bladder and ureters are carefully prepared by cystoscopy and placement of ureteral catheters. This video is suitable for urological surgeons.

English - 06'40'' 00'25''  Cystoscopy 00'50''  Laparoscopic exploration 01'20''  Partial cystectomy 02'55''  Bladder wall closure 05'45''  Coagulation of peritoneal endometriosis

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Laparoscopic transperitoneal pyeloplasty using a remote-controlled robotic surgical system, ureteropyelic junction reconstruction

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This surgical video demonstrates the advantages of using the DaVinci robot for dissection and anastomosis of the upper ureter to the renal pelvis. A potentially difficult procedure is simplified by the dexterity of the robotic instruments.

English - 10'22'' 00'50''  Dissection of ureter and renal vein 02'15''  Division of renal pelvis and ureter 03'20''  Pelvi-ureteric anastomosis 08'10''  Reperitonization

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Laparoscopic robot-assisted living donor nephrectomy

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This video demonstrates laparoscopic robot-assisted living donor nephrectomy. The technique of harvest of both left and right kidneys is shown. The role of the assistant is emphasized, as well as the importance of a counter-incision for delivering the specimen. This is a complex and high-risk procedure for expert laparoscopic surgeons.

English - 06'50'' 00'15''  Left colon mobilization 00'30''  Isolation of left renal pedicle 02'20''  Left kidney harvest 05'00''  Right renal pedicle isolation 06'15''  Hemostasis

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Laparoscopic robotic-assisted partial nephrectomy

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This video describes the procedure of partial nephrectomy performed with the DaVinci robot. The renal pedicle is first isolated and temporarily controlled with vascular clamps. The partial nephrectomy is then performed in a bloodless field.

English - 08'23'' 00'20''  Trocar placement 01'00''  Isolation of renal vessels 02'20''  Renal parenchyma division 04'28''  Suture of kidney remnant 07'50''  Specimen removal and closure of capsular fat

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Robotic sleeve gastrectomy

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This video shows the bariatric procedure of sleeve gastrectomy performed using a daVinci surgical robot. The patient had undergone gastric banding previously so the robot is useful in the dissection of a difficult hiatus, and also for suturing in a confined space. An experienced patient side assistant complements the procedure by performing the stapled resection of the greater curvature of the stomach. This video is suitable for bariatric surgeons.

English - 09'50'' 00'30''  Preparation of robot 04'00''  Dissection of cardia and fundus 06'20''  Dissection of greater curvature 07'45''  Sleeve gastrectomy 08'25''  Suture of staple line

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Robotic-assisted laparoscopic radical prostatectomy

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This video demonstrates robotic radical prostatectomy performed by a highly experienced surgeon. The additional advantages conferred by the dexterity of the multiple robotic instruments in performing this complex surgery is apparent. This video is recommended for urologists with an interest in prostate surgery.