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Robotic total mesorectal excision, a practical solution in an obese female patient

Epublication WebSurg.com, May 2011;11(05). URL: http://websurg.com/doi/vd01en3296

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  • 2011-05-16
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This video describes a practical solution to total mesorectal excision using robotics. The patient is a 55-year-old female with a BMI of 32 and low rectal cancer localized 3cm above the anorectal ring. She also has large uterine fibroids. The patient received preoperative chemoradiation and subsequently underwent a surgical procedure in form of ultra low anterior resection with colonic J pouch creation and protective ileostomy. The concept of the procedure utilizes several surgical techniques which seem to be best suited for an obese patient with locally advanced low rectal cancer. The main emphasis during this presentation is placed on robotic total mesorectal excision. On the other hand, we would like to present a fairly universal approach to any low rectal cancer. Several important issues in regards to the current robotic technology are discussed. These include the obvious advantage in the deep pelvis, hybrid concept, and the answer to the question “Why isn’t the entire procedure performed robotically?”