<scp>RoboLap</scp> cooperative technique for lymphadenectomy in robotic surgery for right‐sided colon cancer—A video vignette

Abstract

Several studies have demonstrated the benefits of combining robotic and laparoscopic techniques in various surgical procedures. These include robotic distal gastrectomy [1], total gastrectomy [2], robotic hepatectomy utilizing a laparoscopic cavitron ultrasonic surgical aspirator [3, 4], and hysteroscopy using robotic and laparoscopic instruments [5]. However, evidence regarding their effectiveness in colorectal surgery is limited. Video 1 presents the RoboLap cooperative technique (RLT) for ensuring safety when performing lymphadenectomy in robotic ileocaecal resection. This approach employs two surgeons. The first operator (robotic operator) controls the robotic arms and maintains a clear view of the dissection field. The second operator (laparoscopic operator) is positioned next to the patient and performs lymph node dissection using an ultrasonically activated device (USAD; Harmonic 1100). The USAD offers several advantages: (1) precise dissection due to the fine shape of the device tips; (2) effective sealing of lymphatic vessels, resulting in a consistently dry surgical field and minimized risk of postoperative lymphatic leakage; and (3) improved access to the surgical trunk from the lower left abdominal port, which is crucial for right-sided colon cancer. In contrast, the multijoint function of robotic forceps is advantageous in areas where laparoscopic linear forceps struggle due to limitations on tangential movement. Furthermore, the stable view provided by the robotic scope improves surgical performance [6]. Thus, RLT can maximize the advantages of both robotic and laparoscopic approaches with the coordinated efforts of two surgeons ensuring safe and efficient lymph node dissection around the superior mesenteric vein. None. The authors declare that they have no conflicts of interest. All the procedures were performed in accordance with the ethical standards of the institutional research committee. Informed consent was obtained from all patients for educational and scientific purposes. Data sharing is not applicable to this article, since no new data were created or analysed in this study.