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Title
1. Introduction
2. Surgical Approach
3. Pfannenstiel Incision and Placement of Ports
4. Robot Docking
5. Lateral-to-Medial Colon Mobilization
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a. Tack Uterus Up and Out of the Way
6. Total Mesorectal Excision (TME) Dissection
7. Determination of Tumor Location and Level of Resection with TilePro and Flexible Sigmoidoscopy
8. Complete Dissection to the Level of Resection
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a. Recheck Locations with TilePro and Flexible Sigmoidoscopy
9. Distal Rectal Division with Stapler
10. Dissection of IMA Pedicle
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a. Divide IMV
b. Divide IMA
11. Determination and Preparation of Proximal Anastomosis Site
12. Check Perfusion of Colon and Rectal Stump
13. Specimen Extraction Through Pfannenstiel Incision and Proximal Bowel Division
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a. Place Purse-String Suture for Anvil
14. Anastomosis with EEA Stapler
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a. Secure Anvil
b. Insert Stapler and Deploy Spike
c. Add Purse-String Suture for Distal End
d. Complete Anastomosis
e. Oversew Anastomosis
15. Air Leak Test for Anastomosis
16. Robot Undocking and Closure
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a. Prepare Diverting Loop Ileostomy Site
b. Diverting Loop Ileostomy Maturation with Terminal Brooke End
17. Post-op Remarks
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Robotic Low Anterior Resection with Diverting Loop Ileostomy for Locally Advanced Rectal Cancer
Jon Harrison, MD
1
;
Todd Francone, MD
1,2
1
Massachusetts General Hospital
2
Newton-Wellesley Hospital
Tags:
General Surgery
Oncologic Surgery
Multidisciplinary Surgery
Main Text
Procedure Outline
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Authors
Jon Harrison, MD
Todd Francone, MD
Filmed At:
Newton-Wellesley Hospital
Article Information
Publication Date
10/17/2022
Article ID
343
Production ID
0343
Volume
2022
Issue
343
DOI
https://doi.org/10.24296/jomi/343