MSS03: ROBOTIC-ASSISTED LAPAROSCOPIC SIGMOIDECTOMY WITH TRANSRECTAL SPECIMEN EXTRACTION FOR RECURRENT DIVERTICULITIS
Carolyn G Judge, MD1; Gordon G Wisbach, MD2; 1Naval Health Clinic Hawaii; 2Naval Medical Center San Diego
Natural orifice specimen extraction (NOSE) is a surgical technique defined by specimen removal via a natural orifice such as the rectum, anal canal, vagina, or mouth with intracorporeal anastomosis. The primary benefit of this technique is reduced access trauma due to avoidance of the mini laparotomy necessary with conventional laparoscopy. It has been associated with less postoperative pain, lower analgesic requirement, faster return of bowel function, and fewer incisional hernias as well as improved cosmetic results. The primary concern with NOSE procedures is peritoneal contamination, however, there is no evidence of associated infectious complications despite near universal contamination. The robotic platform offers enhanced visualization, camera stability, range of motion, and improved ergonomics as well as extended reach. Robotic-assisted NOSE technique is an innovative approach which has the potential to revolutionize minimally invasive surgery due to the avoidance of the mini-laparotomy as well as facilitation of dissection and anastomosis in narrow fields perhaps impossible with laparoscopic instruments. We report a case of recurrent diverticulitis in the setting of a complex abdominal surgical history managed by robotic-assisted laparoscopic sigmoidectomy with transrectal specimen extraction.