THE USE OF NEW TECHNOLOGIES IN ROBOTIC COLORECTAL RESECTIONS: A CASE OF ANTERIOR RECTAL RESECTION USING THE DA VINCI XI, THE INTEGRATED TABLE MOTION, THE ENDOWRIST ROBOTIC STAPLER AND THE INDOCYANINE GREEN FLUORESCENCE

Background/Hypothesis: The use of new technologies in surgery has expanded enormously in recent decades, not only in the consolidated open or laparoscopic surgery, but also and to a greater extent in the new surgical frontier of robotic surgery. We present a case of anterior rectal resection with the Da vinci Xi, the new wireless linked table, the new robotic EndoWrist linear staplers and the indocyanine green fluorescence. Materials and Methods: A 78-years old man with an adenocarcinoma of the rectum. He previously underwent neoadiuvant short course radiotherapy. He was operated on with Da Vinci Xi® platform with left lower quadrant trocar’ disposition. Results: The procedure was successfully completed in 245 min. The patient position was changed twice during the intervention with instruments left inside the abdomen and without undocking the robot. Firstly the patient was arranged for the inferior mesenteric vein, for the splenic flexure and descending colon mobilization and then for Total Mesorectal Excision. No external collision or other problems related to the operating bed was noted. There were no surgical complications or a need for conversion to laparoscopy or laparotomy. The section of the rectum was performed with the new robotic linear staplers with EndoWrist technology. We also used fire fly indocyanine green fluorescence to assess anastomotic perfusion. The patient had an uneventful recovery and he was discharged from hospital after 8 days. Conclusions: The Da Vinci Xi® with the use of new technologies is safe and feasible and appers to give some advantages in colorectal surgery. These new versatile devices offer potential advantages in multi-quadrant surgery such as colorectal resections by reducing the operative time, increasing the ability to perform surgeries with totally robotic technique and making the operations more fluid