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Session: Ongoing Videos

VM6 - Open Assisted Robotic Surgery (OARS) - During A Posterior Exenteration

ONGOING VIDEOS
Location: ASCRS Connect Lounge, Hall B1/B2, Ground Level

    Video Presentation(s)

  • Richard Fortunato, DO (he/him/his)

    Program Director, Colorectal Fellowship
    Allegheny Health Network
    Drexel University College Of Medicine
    Pittsburgh, PA, United States

    Disclosure information not submitted.

    • Author(s)

  • Meagan Derbyshire, MD (she/her/hers)

    Colorectal Fellow
    Allegheny Health Network
    Erie, PA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • SC

    Sricharan Chalikonda, MD

    Chair, Surgical Institute
    Allegheny Health Network
    Pittsburgh, Pennsylvania, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • AV

    Alexandra Vagasi, MD

    Colorectal Surgeon
    Lehigh Valley
    Pittsburgh, Pennsylvania, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Meagan Derbyshire, MD: This individual has no financial relationships with ineligible companies.
Sricharan Chalikonda, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Robotic technology has allowed improved surgical microdissection though high-definition binocular visualization and magnification coupled with instrument reach, variability and dexterity. This surgical approach has specifically benefited colorectal surgeons treating complex and low pelvic tumors. While products exist to allow the interchange between open and minimally invasive surgery, this technique is limited by the length of the incision. Our patient had recurrent anal cancer invading the posterior distal vagina which required a posterior exenteration with cloaca. Due to the defect and previous radiation therapy, she required an open transabdominal rectus flap closure and vaginal reconstruction.

Methods/Interventions: We video describe a novel surgical procedure, herby designated as an open assisted robotic surgery (OARS) - which is a hybrid surgical approach docking the robot in free-space extracorporeally and using the robot and arms as an operating microscope during an open en bloc posterior exenteration.

Results/Outcomes: This approach provided excellent surgical access to the deep pelvis and simultaneously provided all the benefits of robotic technology during a required open operation. The enhanced robotic illumination, visualization, instrumentation and ICG utilization improved our ability to successfully perform a safe, en bloc posterior exenteration.

Conclusion/Discussion: Using our novel open assisted robotic surgery (OARS) hybrid technique, we were able to use all the benefits of robotic technology and perform en bloc microdissection during an open surgery.