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Video preload image for Robotic Low Anterior Resection with Diverting Loop Ileostomy for Locally Advanced Rectal Cancer
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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
  • 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
  • 9. Distal Rectal Division with Stapler
  • 10. Dissection of IMA Pedicle
  • 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
  • 14. Anastomosis with EEA Stapler
  • 15. Air Leak Test for Anastomosis
  • 16. Robot Undocking and Closure
  • 17. Post-op Remarks

Robotic Low Anterior Resection with Diverting Loop Ileostomy for Locally Advanced Rectal Cancer

5534 views

Jon Harrison, MD1; Todd Francone, MD1,2
1Massachusetts General Hospital
2Newton-Wellesley Hospital

General Surgery

Procedure Outline

Table of Contents

  1. 1. Introduction
    1. 2. Surgical Approach
      1. 3. Pfannenstiel Incision and Placement of Ports
        1. 4. Robot Docking
          1. 5. Lateral-to-Medial Colon Mobilization
            1. 6. Total Mesorectal Excision (TME) Dissection
              1. 7. Determination of Tumor Location and Level of Resection with TilePro and Flexible Sigmoidoscopy
                1. 8. Complete Dissection to the Level of Resection
                  1. 9. Distal Rectal Division with Stapler
                    1. 10. Dissection of IMA Pedicle
                      1. 11. Determination and Preparation of Proximal Anastomosis Site
                        1. 12. Check Perfusion of Colon and Rectal Stump
                          1. 13. Specimen Extraction Through Pfannenstiel Incision and Proximal Bowel Division
                            1. 14. Anastomosis with EEA Stapler
                              1. 15. Air Leak Test for Anastomosis
                                1. 16. Robot Undocking and Closure
                                  1. 17. Post-op Remarks
                                    1. Tack Uterus Up and Out of the Way
                                    1. Recheck Locations with TilePro and Flexible Sigmoidoscopy
                                    1. Divide IMV
                                    2. Divide IMA
                                    1. Place Purse-String Suture for Anvil
                                    1. Secure Anvil
                                    2. Insert Stapler and Deploy Spike
                                    3. Add Purse-String Suture for Distal End
                                    4. Complete Anastomosis
                                    5. Oversew Anastomosis
                                    1. Prepare Diverting Loop Ileostomy Site
                                    2. Diverting Loop Ileostomy Maturation with Terminal Brooke End

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                                    Authors

                                    Filmed At:

                                    Newton-Wellesley Hospital

                                    Article Information

                                    Publication Date
                                    Article ID343
                                    Production ID0343
                                    Volume2022
                                    Issue343
                                    DOI
                                    https://doi.org/10.24296/jomi/343