Totally robotic left colectomy.

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Laparoscopic colectomy is challenging due to steep learning curves, limited instrument dexterity, and poor depth perception.
• Robotic left colectomy has utilized single docking or hybrid techniques, but challenges remain with multi-quadrant dissection and instrument collisions.
• Robotic technology offers 3D visualization and enhanced dexterity, potentially increasing minimally invasive surgery adoption.

Purpose of the Study:

• To describe a novel double docking technique for robotic left colectomy.
• To address the challenges of multi-quadrant dissection and splenic flexure dissection in robotic colectomy, particularly in obese patients.

Main Methods:

• Description of a double docking technique for robotic left colectomy.
• Application of the technique to facilitate multi-quadrant dissection and approach challenging anatomical areas like the splenic flexure.

Main Results:

• The double docking technique potentially overcomes limitations of single docking, such as difficult angles and arm collisions.
• This approach may enhance the ability of surgeons to perform complex dissections in multiple quadrants during robotic colectomy.
• The technique is proposed to aid in dissections, especially in challenging cases like obese patients or splenic flexure mobilization.

Conclusions:

• A double docking technique offers a potential solution for complex multi-quadrant dissections in robotic left colectomy.
• This technique may improve the feasibility and adoption of robotic minimally invasive surgery for colectomies.
• Further studies are warranted to evaluate the efficacy and safety of this novel approach.