Robotic-assisted Right Colectomy with Complete Mesocolic Excision: A Technical Standardization of the Medial-to-Lateral Approach, Step-by-Step
Autores
Joana Cracel Lourenço, Marta Marques, Rui Ferreira-Santos, Nuno Gonçalves, Isabel Marques, Manuel Ferreira, Carlos Costa Pereira, Nuno Vilela Pinto, Joaquim Costa Pereira
Resumo Introdução
Minimally invasive surgery has become the gold-standard for right colon cancer, offering faster recovery, shorter hospital length of stay, less intraoperative blood loss and oncologic outcomes comparable to open surgery. Robotic platforms add further benefits, including stable and dexterous instrument control, three-dimensional visualization, precise dissection and the possibility of remote operation.
Resumo Métodos
Clinical case and surgical video presentation.
Resumo Resultados
A 81-year-old woman with ascending colon adenocarcinoma underwent a robotic right hemicolectomy using a medial-to-lateral approach. Medial dissection exposed the ileocolic pedicle and progressed along embryologic planes to the superior mesenteric axis, with ligation of the ileocolic vessels and the right branch of the middle colic (D2 lymphadenectomy). Lateral mobilization preserved the duodenum and pancreatic head, and the hepatic flexure was released. The ileum and transverse colon were divided with staplers, and an intracorporeal side-to-side ileocolic anastomosis was created. The specimen was extracted suprapubically. No surgical complications were reported.
Resumo Discussão
Robotic-assisted medial-to-lateral right hemicolectomy is a safe and effective technique, combining the advantages of MIS with refined vascular and mesocolic dissection. It represents a valuable evolution in the minimally invasive treatment of right colon cancer.