This Video is about Robotic Ultra Low anterior Resection with single docking done at American Oncology Institute, Hyderabad.
Robotic Low anterior resection used to be time consuming with Si HD and Si as its requires dual docking most of the time.With X or Xi robot, docking is done with ease. Its done in the oblique line above umbilicus with R3 & R4 on the right of camera.
Initially for pelvic part R3 uses monopolar scissors and R4 prograsp. We complete the dissection of rectum in pelvis as much as possible and then shift to colonic side. In this phase of lateral and over Pancreas mobilization starts we shuffle R3 &R4. The monopoly in R4 helps to glide over laterally, sweep over Gerota’s fascia and onto to Pancreas and over it. Then we enter the lesser sac visualising the posterior part of stomach. An adequate mobilisation should visualise the lateral pancreas, Posterior stomach and IMA root clip.
Then we transect the left colon at the required level with the Robotic Sureform 45 staplers. We check vascularity with ICG. The robotic staplers are are used to transect below growth. We insert anvil and apply purse string suture and anastomose with EEA stapler.
The colon should and must align with ease in the pelvis and have a good fall.