Robotic Abdominoperineal Resection (APR) with Bilateral Gracilis Muscle Flaps
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Procedure Outline
Table of Contents
- Rectal Exam
- Flexible Sigmoidoscopy
- Marking
- Dock Robot
- Pelvic Brim Dissection
- Examine Redundancy of Sigmoid Colon and Retract out of Pelvis
- Medial-to-Lateral Colon Mobilization Starting at IMA Pedicle
- Pelvic Dissection and Develop Plane
- TME Dissection
- Add 12-mm Port for Stapler
- Division of IMA Pedicle Distal to Left Colic Artery
- Transection of Colon
- Hemostasis
- Suture Drain to Sigmoid Stump
- Left Side
- Right Side
- Close Anus with Purse-String Suture
- Approach
- Take Margins
- Hemostasis
- Review
- Subcutaneous Tunnels to Bring Flaps into Perineum
- Closure of Right Proximal Graft Incision