A novel robotic right colectomy for colon cancer via the suprapubic approach using the da Vinci Xi system: initial clinical experience

Annals of Surgical Treatment and Research 2018³â 94±Ç 2È£ p.83 ~ p.87

ÀÌÈñÀç(Lee Hee-Jae) - Kyungpook National University School of Medicine Kyungpook National University Medical Center Colorectal Cancer Center
ÃÖ±Ô¼®(Choi Gyu-Seog) - Kyungpook National University School of Medicine Kyungpook National University Medical Center Colorectal Cancer Center
¹ÚÁؼ®(Park Jun-Seok) - Kyungpook National University School of Medicine Kyungpook National University Medical Center Colorectal Cancer Center
¹Ú¼ö¿¬(Park Soo-Yeun) - Kyungpook National University School of Medicine Kyungpook National University Medical Center Colorectal Cancer Center
±èÇýÁø(Kim Hye-Jin) - Kyungpook National University School of Medicine Kyungpook National University Medical Center Colorectal Cancer Center
(Woo In-Teak) - Kyungpook National University School of Medicine Kyungpook National University Medical Center Colorectal Cancer Center
¹ÚÀαÔ(Park In-Kyu) - Kyungpook National University School of Medicine Kyungpook National University Medical Center Colorectal Cancer Center

Abstract

Purpose: We developed a technique of totally-robotic right colectomy with D3 lymphadenectomy and intracorporeal anastomosis via a suprapubic transverse linear port. This article aimed to introduce our novel robotic surgical technique and assess the short-term outcomes in a series of five patients.

Methods: All colectomies were performed using the da Vinci Xi system. Four robot trocars were placed transversely in the supra pubic area. Totally-robotic right colectomy was performed, including colonic mobilization, D3 lymphadenectomy, and intra corporeal stapled functional anastomosis. The 2 middle suprapubic trocar incisions were then extended to retrieve the specimen.

Results: Five robotic right colectomies via the suprapubic approach were performed between August 2015 and February 2016. The mean operation time was 183 ¡¾ 29.37 minutes, and the mean estimated blood loss was 27 ¡¾ 9.75 mL. The time to clear liquid intake was 3 days in all patients, and the mean length of stay after surgery was 6.2 ¡¾ 0.55 days. No patient required conversion to conventional laparoscopic surgery. There were no perioperative complications. According to the pathology report, the mean number of harvested lymph nodes was 36.6 ¡¾ 4.45. Four patients were stage III, and 1 patient was stage II according to the 7th edition of the American Joint Committee on Cancer system.

Conclusion: Totally-robotic right colectomy via the suprapubic approach can be performed successfully in selected patients. Further comparative studies are required to verify the clinical advantages of our technique over conventional robotic surgery.

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Robotic surgical procedures, Colectomy, Minimal invasive surgical procedures
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This robotic right colectomy via the suprapubic approach was performed safely and successfully with satisfying short term outcomes in our experience. The mean operation time and estimated blood loss were 183 ¡¾ 29.37 minutes and 27 mL, respectively.
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