Robotic Right Hemicolectomy with Intracorporeal Anastomosis

Abstract

We present the case of a 61 yo male patient with past medical history of sigmoid resection for diverticulitis he presented with right lower quadrant pain and weight loss an 8 cm mass was identified in the cecum on a CT scan After a previous colonoscopy and the identification of an ulcerated fungating mass involving the ileocecal valve cecal, which was unresectable by this means a biopsy was taken, and the diagnosis of an adenocarcinoma was made. Patient was taken to the operating room to do a robotic assisted right hemicolecotmy Previous trocar position, we begin by identifying the ileocolic pedicle and a medial to lateral approach was made, identifying the second portion of the duodenum then we skeletonized, then ligate and divide the ileocolic vessels separately, the superior mesenteric vein was identified distally. We continued with the medial to lateral approach until the identification of the head of the pancreas after that we continued with a lateral mobilization of the right colon. We then proceed to the identification, ligation and division of the right Brach of the middle colic artery with the robotic ultrasonic shears. The transverse colon and the terminal ileum were prepared for division whit the robotic stapler and an intracorporeal laterolateral isoperistaltic ileocolonic anastomosis was fashioned, and the closure of the enerotomy on two layers was performed. At this point the robot was undocked and the specimen was extracted of the abdominal cavity through a Pfannenstiel incision.