Robotic Left Colectomy with Natural Orifice IntraCorporeal Anastomosis with Extraction: The NICE Procedure



Minimally invasive colorectal surgery continues to evolve with new technologies enabling platforms. In particular, advances in robotic surgery have led to renewed interest in natural orifice-assisted surgery with intracorporeal anastomosis (ICA) and transrectal extraction of specimen.


Robotic left colectomy NICE procedure Minimally invasive colorectal surgery Advanced robotic technique Left-sided resection Primary anastomosis 

Supplementary material

Video 7.1

Lateral dissection with release of lateral peritoneal attachments (MP4 9249 kb)

Video 7.2

Identify and isolate proximal level of resection (MP4 13015 kb)

Video 7.3

Divide proximal mesentery (MP4 8769 kb)

Video 7.4

Identify and isolate distal level of resection (MP4 12969 kb)

Video 7.5

Divide proximal margin (MP4 9266 kb)

Video 7.6

Divide the distal margin (MP4 8492 kb)

Video 7.7

Placement of transrectal retractor (MP4 8218 kb)

Video 7.8

Specimen extraction and removal of Alexis (MP4 7705 kb)

Video 7.9

Transrectal delivery of the anvil into the abdomen (MP4 5939 kb)

Video 7.10

Securing anvil to proximal bowel (MP4 27212 kb)

Video 7.11

Close distal bowel around circular stapler (MP4 25455 kb)

Video 7.12

Formation of end-to-end anastomosis (MP4 6786 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Colon and Rectal SurgeryHouston Methodist HospitalHoustonUSA

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