Robotic low anterior resection

The surgical robot is an ideal instrument for use in the pelvis and on the rectum. A low anterior resection can be performed using a totally robotic technique or a laparoscopic hybrid approach. The pre-operative planning for a robotic approach is similar to that of a laparoscopic or traditional open approach. The robotic approach is ideally suited for patients with low or middle rectum pathology, and the only absolute contraindication is inability to tolerate pneumoperitoneum. The operation is performed using four robotic trocar sites, as well as camera and assistant ports. The entire operation can be performed without repositioning the robotic console. There are few potential complications unique to the robotic approach, and the outcomes of robotic low anterior resection appear similar to that of the laparoscopic approach. This article describes the technique of a robotic low anterior resection, including splenic flexure mobilization, total mesorectal excision and specimen extraction, and well the peri-operative management.