Robotic right colectomy with intracorporeal anastomosis for malignancy

Scott R. Kelley, Emilie Duchalais, David Larson

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Techniques for robotic resection of the right colon have not been extensively published or adopted. We report our initial experience of robotic right colectomy with intracorporeal anastomosis and specimen extraction through a Pfannenstiel incision retrospectively. Twenty-one consecutive patients with a right colon cancer (n = 18) or polyp too large to remove endoscopically (n = 3) were treated at Mayo Clinic Rochester, Minnesota. Main outcomes measured were estimated blood loss, operative time, conversion rate, return of gastrointestinal function, length of stay, overall and severe complications, discharge status, and pathology. All 21 procedures were technically successful without the need for conversion. The mean total operative time was 250 ± 56 min, estimated blood loss was less than 100 mL in 19 (90%), only 1 (5%) ileus occurred, mean length of stay and return of gastrointestinal function was 4 ± 1.3 and 1 ± 0.6 days, respectively, only 1 (5%) patient experienced a Dindo grade ≥ 3 complication, and 20 (95%) were discharged to home. Mean number of nodes resected was 26 ± 12. Tumors were diagnosed as stage 0 in 3 (14%), stage I in 7 (33%), stage II in 4 (19%), stage III in 6 (28%), and stage IV in 1 (5%). Main limitations were nonrandomized nature, single institution experience, small patient sample size, and procedures only being performed by two surgeons. Finally, we conclude that robotic right colectomy with central mesocolic excision, intracorporeal anastomosis, and extraction through a Pfannenstiel incision is technically feasible, efficacious, oncologically acceptable, and safe to perform.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalJournal of Robotic Surgery
DOIs
StateAccepted/In press - Oct 25 2017

Fingerprint

Colectomy
Robotics
Operative Time
Length of Stay
Neoplasms
Ileus
Polyps
Sample Size
Colonic Neoplasms
Colon
Pathology

Keywords

  • Central mesocolic excision
  • Intracorporeal anastomosis
  • Robotic right colectomy

ASJC Scopus subject areas

  • Surgery
  • Health Informatics

Cite this

Robotic right colectomy with intracorporeal anastomosis for malignancy. / Kelley, Scott R.; Duchalais, Emilie; Larson, David.

In: Journal of Robotic Surgery, 25.10.2017, p. 1-6.

Research output: Contribution to journalArticle

@article{9160db64a2f34434bdad8bb76806c4af,
title = "Robotic right colectomy with intracorporeal anastomosis for malignancy",
abstract = "Techniques for robotic resection of the right colon have not been extensively published or adopted. We report our initial experience of robotic right colectomy with intracorporeal anastomosis and specimen extraction through a Pfannenstiel incision retrospectively. Twenty-one consecutive patients with a right colon cancer (n = 18) or polyp too large to remove endoscopically (n = 3) were treated at Mayo Clinic Rochester, Minnesota. Main outcomes measured were estimated blood loss, operative time, conversion rate, return of gastrointestinal function, length of stay, overall and severe complications, discharge status, and pathology. All 21 procedures were technically successful without the need for conversion. The mean total operative time was 250 ± 56 min, estimated blood loss was less than 100 mL in 19 (90{\%}), only 1 (5{\%}) ileus occurred, mean length of stay and return of gastrointestinal function was 4 ± 1.3 and 1 ± 0.6 days, respectively, only 1 (5{\%}) patient experienced a Dindo grade ≥ 3 complication, and 20 (95{\%}) were discharged to home. Mean number of nodes resected was 26 ± 12. Tumors were diagnosed as stage 0 in 3 (14{\%}), stage I in 7 (33{\%}), stage II in 4 (19{\%}), stage III in 6 (28{\%}), and stage IV in 1 (5{\%}). Main limitations were nonrandomized nature, single institution experience, small patient sample size, and procedures only being performed by two surgeons. Finally, we conclude that robotic right colectomy with central mesocolic excision, intracorporeal anastomosis, and extraction through a Pfannenstiel incision is technically feasible, efficacious, oncologically acceptable, and safe to perform.",
keywords = "Central mesocolic excision, Intracorporeal anastomosis, Robotic right colectomy",
author = "Kelley, {Scott R.} and Emilie Duchalais and David Larson",
year = "2017",
month = "10",
day = "25",
doi = "10.1007/s11701-017-0759-0",
language = "English (US)",
pages = "1--6",
journal = "Journal of Robotic Surgery",
issn = "1863-2483",
publisher = "Springer London",

}

TY - JOUR

T1 - Robotic right colectomy with intracorporeal anastomosis for malignancy

AU - Kelley, Scott R.

AU - Duchalais, Emilie

AU - Larson, David

PY - 2017/10/25

Y1 - 2017/10/25

N2 - Techniques for robotic resection of the right colon have not been extensively published or adopted. We report our initial experience of robotic right colectomy with intracorporeal anastomosis and specimen extraction through a Pfannenstiel incision retrospectively. Twenty-one consecutive patients with a right colon cancer (n = 18) or polyp too large to remove endoscopically (n = 3) were treated at Mayo Clinic Rochester, Minnesota. Main outcomes measured were estimated blood loss, operative time, conversion rate, return of gastrointestinal function, length of stay, overall and severe complications, discharge status, and pathology. All 21 procedures were technically successful without the need for conversion. The mean total operative time was 250 ± 56 min, estimated blood loss was less than 100 mL in 19 (90%), only 1 (5%) ileus occurred, mean length of stay and return of gastrointestinal function was 4 ± 1.3 and 1 ± 0.6 days, respectively, only 1 (5%) patient experienced a Dindo grade ≥ 3 complication, and 20 (95%) were discharged to home. Mean number of nodes resected was 26 ± 12. Tumors were diagnosed as stage 0 in 3 (14%), stage I in 7 (33%), stage II in 4 (19%), stage III in 6 (28%), and stage IV in 1 (5%). Main limitations were nonrandomized nature, single institution experience, small patient sample size, and procedures only being performed by two surgeons. Finally, we conclude that robotic right colectomy with central mesocolic excision, intracorporeal anastomosis, and extraction through a Pfannenstiel incision is technically feasible, efficacious, oncologically acceptable, and safe to perform.

AB - Techniques for robotic resection of the right colon have not been extensively published or adopted. We report our initial experience of robotic right colectomy with intracorporeal anastomosis and specimen extraction through a Pfannenstiel incision retrospectively. Twenty-one consecutive patients with a right colon cancer (n = 18) or polyp too large to remove endoscopically (n = 3) were treated at Mayo Clinic Rochester, Minnesota. Main outcomes measured were estimated blood loss, operative time, conversion rate, return of gastrointestinal function, length of stay, overall and severe complications, discharge status, and pathology. All 21 procedures were technically successful without the need for conversion. The mean total operative time was 250 ± 56 min, estimated blood loss was less than 100 mL in 19 (90%), only 1 (5%) ileus occurred, mean length of stay and return of gastrointestinal function was 4 ± 1.3 and 1 ± 0.6 days, respectively, only 1 (5%) patient experienced a Dindo grade ≥ 3 complication, and 20 (95%) were discharged to home. Mean number of nodes resected was 26 ± 12. Tumors were diagnosed as stage 0 in 3 (14%), stage I in 7 (33%), stage II in 4 (19%), stage III in 6 (28%), and stage IV in 1 (5%). Main limitations were nonrandomized nature, single institution experience, small patient sample size, and procedures only being performed by two surgeons. Finally, we conclude that robotic right colectomy with central mesocolic excision, intracorporeal anastomosis, and extraction through a Pfannenstiel incision is technically feasible, efficacious, oncologically acceptable, and safe to perform.

KW - Central mesocolic excision

KW - Intracorporeal anastomosis

KW - Robotic right colectomy

UR - http://www.scopus.com/inward/record.url?scp=85032224343&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032224343&partnerID=8YFLogxK

U2 - 10.1007/s11701-017-0759-0

DO - 10.1007/s11701-017-0759-0

M3 - Article

C2 - 29071484

AN - SCOPUS:85032224343

SP - 1

EP - 6

JO - Journal of Robotic Surgery

JF - Journal of Robotic Surgery

SN - 1863-2483

ER -