Robotic NICE Procedure Using Handsewn Technique

Abstract

In 2018, we described a robotic natural orifice-assisted left-sided colorectal resection with intracorporeal anastomosis and transrectal extraction of the specimen and termed it the natural orifice intracorporeal anastomosis with transrectal extraction procedure. More recently, we have explored the feasibility, safety, and utility of performing total handsewn intracorporeal anastomosis. We present a technical video and initial experience depicting the unique steps to accomplish this procedure with colorectal end-to-end handsewn anastomosis.TECHNIQUE: Twenty natural orifice intracorporeal anastomosis with transrectal extraction procedures with end-to-end handsewn intracorporeal anastomosis were performed. A video depicting the essential steps with 2 variations of the handsewn techniques is presented along with short-term outcomes. RESULTS:The most common indication was complicated diverticulitis followed by rectal cancer and deep infiltrative endometriosis of the rectum. The mean operative time was 235 minutes (99-294 min), and there were no intraoperative complications or conversions.

A precise approach to robotic intracorporeal rectal transection and hand‐sewn purse‐string anastomosis for low anterior resection

“…Recently, Haas et al 12 described robotic anastomosis using a handsewn technique, demonstrating its feasibility for various pathologies; however, this technique was validated in only 3 patients. This study employed linear stapler transection, followed by staple line resection for anastomosis.…”