Difficult Dissection during a Low Anterior Resection

Temporal Artery Biopsy – gold standard for the diagnosis of temporal (giant cell) arteritis

As technique and technology have evolved in the modern age, surgical emphasis has shifted steadily towards minimally invasive alternatives. In colon surgery, laparoscopy has been shown to improve multiple outcome metrics, including reductions in post-operative morbidity, pain, and hospital length of stay, while maintaining surgical success rates. Unfortunately, despite the minimally invasive approach, elective laparoscopic sigmoidectomy typically requires an abdominal wall extraction site, leaving a large incision in addition to the laparoscopic port sites. It also utilizes three different types of intestinal staplers, leading to an anastomosis that may have multiple intersecting staple lines, thereby potentially influencing the anastomotic integrity, as well as increasing procedural costs substantially.
We present a case of a totally robotic sigmoidectomy utilizing a single stapler technique and natural orifice specimen extraction in a patient with multiple, severe, recurrent episodes of sigmoid diverticulitis over a 2-year period.

Authors:

First author: Dr. Thammineedi Subramanyeshwar Rao, M.S, MCh, FMAS

Corresponding author: Dr. R Rajagopalan Iyer, DNB,FSOG,MNAMS,FMAS

Third author: Dr. Srijan Shukla, M.S,FMAS

Affiliation of all authors: Basavatarakam Indo-American Cancer Institute and Research Centre,

Road no. 10, Banjara Hills, Hyderabad, Telangana, India; PIN: 500034

Corresponding author’s mailing address: Department of Surgical Oncology, 4th floor, Block 1, Basavatarakam Indo American Cancer Hospital, Road no. 10, Banjara Hills, Hyderabad, Telangana, India; PIN: 500034

Corresponding author’s email address: rajagopalan99@hotmail.com

Disclosure/ Conflict of interest: The authors whose names are listed above certify that they have NO affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers ’bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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