Robotische Hemikolektomie rechts mit kompletter mesokolischer Exzision (CME): Das suprapubische Bottom-to-up-Prinzip mit fluoreszenzangiografiegesteuerter Darmtranssektion und intrakorporaler Ileotransversostomie – eine Videovignette

Impact of ASA-score, age and learning curve on early outcome in the initiation phase of an oncological robotic colorectal program

“…As expected, there was a significant reduction of operation times towards the second phase of this program at our institution as observed by others representing an important aspect of a learning curve. Further, we were able to improve the lymph node yield in the second phase due to a technical modification of CME in the course of right colectomy as reported previously 31,32 . A second technical aspect of improvement of our program was the implementation of fascial sutures of all trocar incisions-a measure that resulted in a lack of further trocar related herniations, as reported by others with robotic surgery of the abdomen 33 .…”

“…Pneumoperitoneum was set to a pressure of 10 to 12 mm Hg. For right hemicolectomy, we used the suprapubic robotic trocar setup, positioning the 4 ports along a horizontal line 3-5 cm above the pubis with a spacing of 7-8 cm plus 1 OR-table assistant operated 13 mm-trocar in the left lateral abdomen as reported previously 31,32 . These patients were positioned in a 23° to 25° head down and 12° to 14° left sided orientation of www.nature.com/scientificreports/ the OR-table that provides an optimal position for retro-colic dissection as well as superior-mesenteric vesseldevelopment with central vascular ligation.…”