Background:Rectal cancer surgery could be a valid benchmark for testing the new robotic Da Vinci Xi because of its multi-quadrant approach for splenic and left colon mobilization and the need to deal with the risks of external collision and problems related to rectal transection down the pelvis. Moreover, the availability of the specific, movable with docked robot, operating table, and the robotic endo-stapler could further improve and simplify colorectal surgery. We present our first case of intersphincteric resection using Da Vinci Xi and the specific operating table. Materials and methods: A 71-years old woman with a very low lying rectal cancer was referred to our center.She was operated on with Da Vinci Xi® platform with left lower quadrant trocar’ disposition. The patient position changed three times during the intervention with instruments left inside the abdomen and without undocking the robot. Firstly the patient was arranged in 10° Trendelenburg and tilted to the right for inferior mesenteric vein, then in 8 °reverse Trendelenburg position for the splenic flexure mobilization. Finally for Total Mesorectal Excision we use a 20° Trendelenburg. The perineal phase was easy to performed because of the previous trans-abdominal intersphincteric dissection and consist in hand sewn colo-anal-anastomosis. Results: The procedure was successfully completed in 300 min. No external collision or other problems related to the operating bed was noted. There were no surgical complications or a need for conversion to laparoscopy or laparotomy. The patient have an uneventful recovery and she was discharged from hospital after 6 days. Conclusions: The Da Vinci Xi® with the specific table motion seems to give some advantages in multi-quadrant surgery in term ofoperating time because the patient can be moved without undocking the robotic platform. The procedure is safe and the splenic flexure as well as the intersphincteric space is easily accessible.
ROBOTIC INTERSFINTERIC RESECTION WITH THE DA VINCI Xi AND THE BLUETOOTH LINKED TABLE MOTION
MORELLI, LUCA;GUADAGNI, SIMONE;DI FRANCO, GREGORIO;PALMERI, MATTEO;BIANCHINI, MATTEO;FANTACCI, RITA;COBUCCIO, LUIGI;Melfi, F;DI CANDIO, GIULIO;MOSCA, FRANCO
2015-01-01
Abstract
Background:Rectal cancer surgery could be a valid benchmark for testing the new robotic Da Vinci Xi because of its multi-quadrant approach for splenic and left colon mobilization and the need to deal with the risks of external collision and problems related to rectal transection down the pelvis. Moreover, the availability of the specific, movable with docked robot, operating table, and the robotic endo-stapler could further improve and simplify colorectal surgery. We present our first case of intersphincteric resection using Da Vinci Xi and the specific operating table. Materials and methods: A 71-years old woman with a very low lying rectal cancer was referred to our center.She was operated on with Da Vinci Xi® platform with left lower quadrant trocar’ disposition. The patient position changed three times during the intervention with instruments left inside the abdomen and without undocking the robot. Firstly the patient was arranged in 10° Trendelenburg and tilted to the right for inferior mesenteric vein, then in 8 °reverse Trendelenburg position for the splenic flexure mobilization. Finally for Total Mesorectal Excision we use a 20° Trendelenburg. The perineal phase was easy to performed because of the previous trans-abdominal intersphincteric dissection and consist in hand sewn colo-anal-anastomosis. Results: The procedure was successfully completed in 300 min. No external collision or other problems related to the operating bed was noted. There were no surgical complications or a need for conversion to laparoscopy or laparotomy. The patient have an uneventful recovery and she was discharged from hospital after 6 days. Conclusions: The Da Vinci Xi® with the specific table motion seems to give some advantages in multi-quadrant surgery in term ofoperating time because the patient can be moved without undocking the robotic platform. The procedure is safe and the splenic flexure as well as the intersphincteric space is easily accessible.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
