Neurovascular sparing robotic high anterior resection–technical note and video vignette
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Preservation of the inferior mesenteric artery (IMA) during high anterior resection (HAR) for benign disease has been shown to reduce the risk of anastomotic leak and is associated with improved functional outcome [1, 2].
We used the da Vinci Xi™ (dVXi) Robotic System (Intuitive Surgery, Sunnyvale, CA, USA) to perform HAR for diverticular disease with sparing of the IMA, superior rectal artery, and hypogastric nerves. The fundamental points of this robotic neurovascular sparing technique, as opposed to a standard robotic HAR, are a lateral-to-medial mobilisation of the left colon and an early division of the upper rectum before division of the colonic mesentery.
Indocyanine green fluorescence angiography (ICGFA) was used to visually confirm perfusion at anastomotic ends and guide colonic transection level prior to performing stapled anastomosis to help reduce risk of anastomotic leak .
The patient in this video is a 68-year-old female who had previously presented...
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any research on human participants or animals performed by any of the authors. It describes modification of a technique of an established surgical procedure.
Informed consent has been obtained from the patient involved as well as clearance from the primary treating surgeon.
Video: Neurovascular sparing robotic high anterior resection technique video (MP4 314424 KB)
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