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Contributors: Craig Rezac, MD
Treatment for recurrent or complicated diverticulitis is surgical resection. Minimally invasive techniques are associated with decreased length of stay and decreased post operative pain. However, laparoscopic low anterior resection is challenging especially in the narrow pelvis. Robotic surgery may overcome these obstacles and allow more surgery for divertiuclitis to be performed minimally invasively.
These surgeons always do a LAR for diverticulitis because they transect on the proximal rectum. They take down the lateral stalks in order to mobilize the rectum and get the eea stapler through the rectum easier.
Bilateral ureteral stents are routinely placed to better identify the ureters. This is especially important in cases of chronic/active diverticulitis or diverticulitis that has been complicated by abscess or fistula. This is the preference of the surgeon.
DOI# http://dx.doi.org/10.17797/y1f1omu3mt
Robotic assisted low anterior resection
Recurrent diverticulitis, complicated diverticulitis
Perforation, fecal peritonitis, extensive previous surgical history (relative)
Firefly
Robotic Stapler
Robotic Surgical System
Modified dorsal lithotomy, preoperative bilateral ureteral stents, robot docked to the left of the patient
Cat scan of the abdomen and pelvis, colonoscopy
Sacral promontory, peritoneal reflection, common iliac bifurcation, white line of Toldt
The major risks to the procedure include anastomotic leak and ureteral injury.
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