Ramon O Minjares-Granillo1, Bertha A Dimas1, Jean-Paul J LeFave2, Eric M Haas3. 1. Department of Surgery, Division of Minimally Invasive Colon and Rectal Surgery, The University of Texas Medical School at Houston, Houston, TX, USA; South East Clinical Research Associates, Inc, Houston, TX, USA. 2. Department of Surgery, Division of Minimally Invasive Colon and Rectal Surgery, The University of Texas Medical School at Houston, Houston, TX, USA; Division of Colon and Rectal Surgery, Houston Methodist Hospital, Houston, TX, USA; South East Clinical Research Associates, Inc, Houston, TX, USA. 3. Department of Surgery, Division of Minimally Invasive Colon and Rectal Surgery, The University of Texas Medical School at Houston, Houston, TX, USA; Division of Colon and Rectal Surgery, Houston Methodist Hospital, Houston, TX, USA; South East Clinical Research Associates, Inc, Houston, TX, USA. Electronic address: ehaasmd@houstoncolon.com.
Abstract
BACKGROUND: Despite numerous benefits, only a small fraction of laparoscopic left-sided colectomy is accomplished without the need for an abdominal incision to retrieve the specimen and prepare for anastomosis. We report our early experience with a robotic approach using Natural orifice IntraCorporeal anastomosis with Extraction of specimen (NICE) to help overcome the technical limitations and challenges of this approach. METHODS: Twenty consecutive patients presented for elective sigmoid or rectosigmoid resection for benign and malignant disease and underwent the NICE procedure. Safety, feasibility and post-operative outcomes were analyzed. RESULTS: Intracorporeal anastomosis was accomplished in all patients. One patient required an abdominal incision to extract a bulky tumor. Mean operative time was 222 min (146-344). Mean time to first flatus and length of stay was 23 and 49 h, respectively. All but 4 patients were discharged home on post-operative day 2. One patient was readmitted with a pelvic fluid collection. CONCLUSION: Robotic left-sided colorectal resection with NICE procedure is a safe and feasible minimally invasive approach and may facilitate greater adoption rates of this technique.
BACKGROUND: Despite numerous benefits, only a small fraction of laparoscopic left-sided colectomy is accomplished without the need for an abdominal incision to retrieve the specimen and prepare for anastomosis. We report our early experience with a robotic approach using Natural orifice IntraCorporeal anastomosis with Extraction of specimen (NICE) to help overcome the technical limitations and challenges of this approach. METHODS: Twenty consecutive patients presented for elective sigmoid or rectosigmoid resection for benign and malignant disease and underwent the NICE procedure. Safety, feasibility and post-operative outcomes were analyzed. RESULTS: Intracorporeal anastomosis was accomplished in all patients. One patient required an abdominal incision to extract a bulky tumor. Mean operative time was 222 min (146-344). Mean time to first flatus and length of stay was 23 and 49 h, respectively. All but 4 patients were discharged home on post-operative day 2. One patient was readmitted with a pelvic fluid collection. CONCLUSION: Robotic left-sided colorectal resection with NICE procedure is a safe and feasible minimally invasive approach and may facilitate greater adoption rates of this technique.
Authors: Eric M Haas; Roberto Luna-Saracho; Jetsen A Rodriguez-Silva; Jose I Ortiz De Elguea-Lizarraga; Jean-Paul LeFave Journal: Dis Colon Rectum Date: 2022-05-01 Impact factor: 4.585