Skip to main content
2025 ASCRS Annual Scientific Meeting Main banner
Final Program


Visit ASCRS U
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
CME
CME
Invitation/Ticketed Event
Invitation/Ticketed Event
Invited Lectureship
Invited Lectureship
Award Recipient
Award Recipient
Self-Assessment
Self-Assessment
Social
Social
Industry
Industry
Back

Session: ePoster: Colon and Colorectal Cancer 4 (Sun1230)

EP435 - Bottom-up Approach to Robotic Right Colectomy--An Introduction to a Novel and Safe Technique

Sunday, May 11, 2025
12:51 PM – 12:56 PM PT
Location: Monitor 5, Sails Pavilion, Upper Level

    Senior Author(s)

  • Craig H. Olson, MD

    Colorectal Surgeon
    Baylor Scott and White Waxahachie
    Texas A&M Medical School
    Waxahachie, Texas, United States

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

    • ePoster Presenter(s)

  • Stacy Nguyen, MD (she/her/hers)

    General Surgery Resident
    Baylor Scott and White
    Dallas, TX, United States

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

    • Author(s)

  • VM

    Vijay Muraliraj, MD

    Staff Surgeon
    Baylor Scott and White
    DALLAS, Texas, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Craig H. Olson, MD: This individual has no relevant relationships with ineligible companies.
Stacy Nguyen, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The traditional technique for a robotic approach to a right colectomy includes three robotic arm ports placed from suprapubic region in line to the left upper quadrant, typically with an assist port in the left abdomen for a medial to lateral mobilization of the right colon [1]. One of these incisions can then be extended into a mini-laparotomy incision or Pfannenstiel incision for the specimen extraction site. While there are slight variations to this technique based on surgeon preference, there has not been much deviation from this general principle. One study has shown a novel bottom-up technique using ports placed transversely along the inferior abdomen and mobilizing the right colon from bottom to top compared to the medial to lateral technique can play a role in complete mesocolic excision [2]. We propose that use of a similar technique of low transverse port placement, Pfannenstiel extraction site, and bottom-up mobilization compared to the traditional robotic right colectomy can be a safe and equivalent option with potential ancillary benefits.

Methods/Interventions: This study was a retrospective chart review of patients who underwent right hemicolectomy (laparoscopic vs robotic) from 2021-2024 with a single surgeon. The patients were separated into groups based on a robotic approach with low transverse port placement versus a standard multiport laparoscopic approach, both utilizing intracorporeal anastomosis. Between the groups, we directly compared in-hospital outcome variables including operation time from incision to closure, conversion to open rates, blood loss, number of lymph nodes harvested, length of hospital stay, and post-operative complications.

Results/Outcomes: Ten patients underwent laparoscopic right colectomy during the study period compared to 28 patients who underwent robotic right colectomy. For each of the variables listed above, compared to the traditional approach, the robotic approach with low transverse port sites had a significantly longer length of operation: 155min vs 128 min (p= 0.01) OR times and a significantly shorter length of hospital stay: 2.1 days vs. 3.3 days (p=0.03). No significant difference was seen in blood loss (52mL vs 50mL), number of lymph nodes harvested (25 vs 23), and post operative complications (1 vs 1). Neither group had any conversion to open surgery.

Conclusion/Discussion: The robotic, low-transverse approach to a right colectomy is a novel, non-inferior approach for right colectomies and can be considered based on surgeon and patient preferences. Additional benefits may lead to a shorter length of stay, however this requires further study.