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- Title
A seven-step dissection technique for robotic total mesorectal excision of rectal cancer.
- Authors
Numata, M.; Sawazaki, S.; Kazama, K.; Aoyama, T.; Tamagawa, H.; Sato, T.; Mushiake, H.; Yukawa, N.; Shiozawa, M.; Masuda, M.; Rino, Y.
- Abstract
The 3rd arm gently grasps the mesentery upward, and 2nd arm pulls the retroperitoneum downward for countertraction; the dissection between the retroperitoneum and left-sided colonic mesentery, from medially to laterally, is performed. Counter traction, formed by the 2nd arm grasping the anterior wall of the rectum and the 3rd arm grasping the peritoneum of the pelvic wall, will enable linear dissection line visualization (Fig. Hence, sufficient Z axis traction should be confirmed first; then, the medial traction of the rectum by the 2nd arm and the lateral traction by the 3rd arm will allow visualization of the border between the mesorectum and the NVB (Fig. Our procedure allows dissection of the anterior and posterior antecedent to the lateral demanding field, which visualizes the sandwiched lateral dissection line.
- Subjects
RECTAL surgery; RECTAL cancer; ONCOLOGIC surgery; SURGICAL excision; MESENTERIC veins; ROBOTICS
- Publication
Techniques in Coloproctology, 2019, Vol 23, Issue 9, p913
- ISSN
1123-6337
- Publication type
Article
- DOI
10.1007/s10151-019-02081-z