key: cord-343393-8hdygwip
authors: Kudsi, Omar Yusef; Chang, Karen; Bou‐Ayash, Naseem
title: Robotic Low Anterior Resection for a Distal Sigmoid Colon Cancer during the COVID‐19 Pandemic – a Video Vignette
date: 2020-08-13
journal: Colorectal Dis
DOI: 10.1111/codi.15310
sha: 
doc_id: 343393
cord_uid: 8hdygwip

The COVID‐19 pandemic brings unprecedented challenges for both surgeons and patients. For patients who still require surgical management during this time, measures to decrease exposure risk during their hospitalization should be a priority. Minimally invasive approaches to low anterior resections (LAR) have been shown to result in early return of bowel function and a short length of stay.

This article is protected by copyright. All rights reserved A 52-year-old male presented with symptomatic rectal bleeding. A colonoscopy revealed an obstructing mass at the rectosigmoid level, which was biopsied and found positive for high-grade adenocarcinoma. Further work-up with MRI and CT scans was negative for any distant metastases and the patient was scheduled for a LAR (Video S1). The operation involved four robotic arms and began by medial-to-lateral mesocolic dissection. A fully robotic partial mesorectal excision was achieved using a stapler after direct proctoscopy identified the appropriate transection level 5cm from the anal verge. Specimen extraction through a port incision was followed by an end-to-end anastomosis using a circular stapler (EEA), with subsequent assessment of vascularization and an airleak test. The postoperative course was uncomplicated and the patient was discharged on postoperative day-2 after the return of normal bowel activity.

Several recommendations regarding the surgical response to the COVID-19 crisis were followed perioperatively [2] [3] [4] . Accordingly, the measures taken during this operation included strict pneumoperitoneum release through a smoke evacuation system and adequate protective equipment for all OR members.

Laparoscopic vs. open total mesorectal excision in unselected patients with rectal cancer: impact on early outcome

Sages and eaes recommendations regarding surgical response to covid-19 crisis

How to manage smoke evacuation and filter pneumoperitoneum during laparoscopy to minimize potential viral spread: different methods from SoMe

Coronavirus pandemic and Colorectal surgery: practical advice based on the Italian experience

Accepted Article