We use cookies to offer you an optimal experience on our website. By browsing our website, you accept the use of cookies.

You must be logged in to watch this video. Click here to access your account, or here to register for free!

  • 788
  • 2009-07-16

Totally robotic low anterior resection (RLAR) with trans-anal specimen extraction and single stapling technique

Epublication WebSurg.com, Jul 2009;09(07). URL:
You must be logged in to ask a question to authors. Click here to access your account, or here to register for free!
We present the case of a 76-year-old woman with a low rectal cancer (T3N0 at 7cm) status post-chemoradiation therapy. Using a four-arm DaVinci system, we carry out the dissection in a medial to lateral fashion dividing the inferior mesenteric vessels and mobilizing the splenic flexure. A total mesorectal excision is performed to the level of the pelvic floor. The specimen is delivered through a wound protector covering the anus. The sigmoid colon is divided extracorporeally, an anvil is secured. Using robotic instruments, a purse-string is sutured to the rectal stump and tied around the EEA stapler spike. An end-to-end anastomosis is created under vision. A diverting ileostomy is performed. This novel robotic procedure eliminates the need for an incision for specimen extraction and may facilitate transection of the rectum during RLAR.