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A novel approach for robotic mobilization of the splenic flexure

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Abstract

Background

The techniques of robotic splenic flexure mobilization in the colorectal surgery setting are not well defined and have been challenging due to limited range of motion of the second-generation robotic platform in multiple quadrants.

Methods

This report describes a novel technique for robotic splenic flexure mobilization with medial-to-lateral approach without a need for robotic cart repositioning during left-sided colon and rectal surgery. The dissection is started with ligation of the inferior mesenteric artery and vein. Unique in this approach, entering the lesser sac is accomplished by extension of the dissection cranially by lifting up the mesocolon from the anterior surface of the pancreatic body toward the stomach.

Results

This technique presented in the video allows the mobilization of the splenic flexure without excessive tractions and avoidance of potential splenic injuries.

Conclusions

The described novel approach demonstrates total robotic splenic flexure takedown without excessive traction, with improved visualization, and reduction of potential risk of splenic injury. This approach provides totally robotic mobilization of the splenic flexure at single docking without changing the patient’s position.

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Corresponding author

Correspondence to E. Gorgun.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study ethical approval is not necessary.

Informed consent

Informed consent was obtained from the patient.

Additional information

Selected for video presentation for the Ongoing Video Room at the upcoming ASCRS Annual Scientific Meeting, April 30–May 4, 2016, Los Angeles, CA.

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Isik, O., Benlice, C. & Gorgun, E. A novel approach for robotic mobilization of the splenic flexure. Tech Coloproctol 21, 53–57 (2017). https://doi.org/10.1007/s10151-016-1572-x

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  • DOI: https://doi.org/10.1007/s10151-016-1572-x

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