Contributors: Benjamin Biteman and Vincent Obias
Robotic Transanal minimally invasive surgical removal of 1.8cm villous adenoma with high grade dysplasia at 22cm.
DOI#:https://doi.org/10.17797/kzimoid3xj
Editor Recruited By: Vincent Obias
Video Author: MD
Robotic Sigmoid resection for Colovesicular Fistula and use of Firefly
Contributors: Ben Biteman, MD
61 year old male with diverticulitis and colovesicular fistula. Patient underwent robotic sigmoid colectomy with takedown of fistula. Firefly used to help identify if fistula still present.
Editor Recruited By: Vincent Obias, MD, MS
DOI# http://dx.doi.org/10.17797/9qxwhlr1q5
Robotic Assisted Redo Rectopexy and Low Anterior Resection
Contributors: Craig Rezac, MD
Low anterior resection and rectopexy is the optimal treatment for well functioning patients with rectal prolapse. Reoperations for rectal prolapse may be challenging due to significant adhesions. Use of the robot for low anterior resection and rectopexy is safe, feasible and may be more useful than laparoscopy especially in challenging cases.
DOI:http://dx.doi.org/10.17797/vkp7axh60l
Novel use of a balloon for bronchial bead foreign body removal
Contributors: Josephine Czechowicz and Sanjay Parikh
Removal of a bronchial foreign body with a smooth surface can be challenging with standard optical forceps. The fogarty arterial embolectomy catheter is a suitable alternative, particularly in the setting of a bead or other hollow object.
DOI: http://dx.doi.org/10.17797/7gq2gil0v3
Editor Recruited by: Sanjay Parikh
Low Anterior Resection for Diverticulitis
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
Completely Robotic Total Proctocolectomy and Ileal Pouch Anal Anastomosis
Contributors: Nell Maloney Patel, MD and Craig Rezac, MD
There is little role for the use of minimally invasive techniques in the emergent setting for ulcerative colitis. However, for elective procedures, studies have shown that laparoscopic restorative proctocolectomy with IPAA is equivalent to open IPAA with regards to safety and feasibility, and that laparoscopic IPAA is associated with shorter recovery times, earlier return to bowel function, less post operative pain and a better cosmetic result. However laparoscopic approaches are difficult especially in the narrow pelvis. These challenges maybe overcome with the daVinci robotic system.
DOI:http://dx.doi.org/10.17797/r1oi8fx5c2
Editor Recruited by: Neil Tanna
Robotic Assisted Type 1 Laryngeal Cleft Repair
Contributors: Umamaheshwar Duvvuri (University of Pittsburgh Medical Center)
A DaVinci Robot is used to dock in with a 30 degree up telescope.The oral cavity is exposed using a FK retractor or a modified McIvor mouth gag( one with a flat blade). Robotic 5 mm Maryland forceps and 5 mm monopolar diathermy forceps is used. After getting a good exposure of the laryngeal cleft the diathermy at a setting of 4-5 watts is used to make the incision.and using the maryland forceps the laryngeal and esophageal flaps are created.A 5.0 PDS suture with a P2 tapered needle is used.The apex of the esophageal flap is first closed with suturing it.After this the apex of the laryngeal surface is closed.For a laryngeal cleft repair 2-4 sutures are required to obtain a closure. The sutures on the laryngeal surface are buried.The patient is kept intubated for a day or two to avoid excess movement of larynx. Pre and post operative treatment of reflux is important for healing.
DOI: http://dx.doi.org/10.17797/z17zngnuwp
Laparoscopic Completion Right Adrenalectomy after Open Left Adrenalectomy and Partial Right Adrenalectomy for Pheochromocytoma
Contributors: Charles M Leys
This video will depict the salient steps in performing a laparoscopic completion right adrenalectomy in a teenager who has previously undergone an open left adrenalectomy and partial right adrenalectomy five years earlier for pheochromocytoma.
DOI: http://dx.doi.org/10.17797/ftk20lm0ez
Laparoscopy for Contralateral Patent Processus Vaginalis
This video depicts several findings on the contralateral inguinal region when performing a diagnostic laparosocpy at the time of open repair of a unilateral inguinal hernia.
DOI: http://dx.doi.org/10.17797/w6xnoqy0un
Lateral Temporal Bone Resection
Contributors: Paul W. Gidley, MD
This video demonstrates the basic steps of lateral temporal bone resection for cancers involving the ear canal. The lateral temporal bone resection removes the ear canal en bloc, preserving the facial nerve and stapes.
DOI: http://dx.doi.org/10.17797/mn4edyy57u
Editor Recruited By: Ravi N. Samy, MD, FACS