This is a 60 yo woman with diverticulitis not responsive to medical management. Open, laparoscopic, and robotic operative options were discussed. We agreed on robotic sigmoid resection in the Enhanced Recovery Pathway. This video demonstrates an intracorporeal colorectal anastomosis between the descending colon and upper rectum. Sigmoid colectomies are typically characterized by by specimen extraction through an open incision after minimally invasive mobilization of the colon and mesentery, placement of an anvil into the descending colon through this open incision, and then laparoscopic or robotic colorectal anastomosis with a circular stapler after re-establishing pneumoperitoneum. This intracorporeal anastomosis does not require stretching colon and mesentery to an open extraction site with the possible need for extending the open incision. There is less visceral manipulation and potentially less ileus and quicker return to gastrointestinal activity. The extraction site can be anywhere the surgeon chooses and the extraction incision size is limited only by the sixe of the pathology.
DOI # http://dx.doi.org/10.17797/p11gskfc90
Recruited By: Vincent Obias