Robotic right colectomy suprapubic approach using da Vinci Xi

This film presents the case of an 85-year-old man who suffered from primary hyperparathyroidism diagnosed on a pathological cervical fracture and elevated laboratory values for parathyroid hormone and calcium. Preoperative localizing studies showed no anomalies on the parathyroid gland. However, a left anterior mediastinal ectopic parathyroid adenoma was found on 99m Tc-MIBI scintigraphy.
Mediastinal parathyroid adenomas can be resected in a minimally invasive fashion via a conventional transcervical approach, or using a video-assisted thoracoscopic resection, allowing for an access to the lower cervical area without the use of a cervicotomy. Robotic-assisted thoracic surgery (RATS) also allows for a better visualization and less instrument crowding, with no difference in clinical results.
Considering the good efficacy and the better chances not to leave tumor tissue missed out during surgery, and the impossibility to install the patient with cervical hyperextension, we decided to perform a robot-assisted thoracoscopy through a left-sided approach, instead of the conventional transcervical approach.
During the intraoperative period, the adenoma was identified, and we did not feel the need to perform PTH assay. There were no complications in the postoperative period. PTH levels reached a normal range after adenoma removal, and the patient was discharged on postoperative day 3. He remains asymptomatic at 3 months after the intervention.
The robotic resection of an intrathymic parathyroid adenoma is a safe and effective alternative to the conventional transcervical approach.

The objective of this film is to demonstrate our operative technique of robotic-assisted laparoscopic radical prostatectomy by Richard Gaston from the Saint Augustin Clinic in Bordeaux. Robotic radical prostatectomy has been performed in our clinic since December 2005. We currently use the Intuitive 4 arm DaVinci system.

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.

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.

Robotic-assisted partial nephrectomy (RAPN) has become increasingly important in the field of minimally invasive surgery of the kidney and the prostate. This technique presents many advantages and helps with the exposure of all anatomical details (vessels included). It allows surgeons to make a very easy and precise dissection of the hilum, and provides an excellent view of renal masses. This allows to precisely cut off masses and differentiate them from normal renal parenchyma. The use of the robot is time-saving and allows for an easy exposure, suture, and closure of the kidney.

Localized renal cancers are best managed by partial nephrectomy. In this lecture, Dr. Thierry Piéchaud focuses on the interest of the robotic approach.

This is the clinical case of a rectal adenocarcinoma located 4cm from the anal verge, following neoadjuvant radiochemotherapy. After initial complete clinical response, during a watch-and-wait protocol, a lesion regrowth was observed 14 months later, necessitating a surgical oncological approach. In this video, authors present a robot-assisted low anterior resection with TME and intersphincteric resection (coloanal anastomosis without ileostomy).

In this lecture, Dr. Vaessen presents the current indications and benefits of robotic nephrectomy.

In this lecture, Doctor Alex Mottrie shows the current indications of urological robotic procedures, and presents the Guidelines on Renal Cell Carcinoma, the techniques of partial nephrectomy, tumor enucleation and renorrhaphy. He presents his experience and his results in a series of 62 patients.

This is the case of a robotic pancreaticoduodenectomy for an intraductal papillary mucinous neoplasm (IPMN) performed in a 50-year-old patient discovered on pancreatic MRI after three episodes of acute pancreatitis.