One‐step totally robotic Hartmann reversal and complex abdominal wall reconstruction with bilateral posterior component separation: a technical note

Aim This paper describes a robotic approach to combined gastrointestinal continuity restoration and complex abdominal wall reconstruction after Hartmann's procedure complicated by large midline and parastomal hernias. Methods A robotic Hartmann reversal is performed, followed by robotic retromu...

Full description

Saved in:
Bibliographic Details
Published in:Colorectal disease 2023-07, Vol.25 (7), p.1523-1528
Main Authors: Douissard, Jonathan, Dupuis, Arnaud, Ris, Frederic, Hagen, Monika E., Toso, Christian, Buchs, Nicolas C.
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Muscles - surgery
Abdominal wall
Abdominal Wall - surgery
abdominal wall reconstruction
Abdominoplasty - methods
colostomy closure
Gastrointestinal tract
Hartmann reversal
Hernia, Ventral - surgery
Herniorrhaphy - methods
Humans
parastomal hernia
posterior component separation
Reconstructive surgery
Rehabilitation
robotic surgery
Robotic Surgical Procedures - methods
Robotics
surgical complications
Surgical Mesh - adverse effects
transversus abdominis release
ventral hernia
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aim This paper describes a robotic approach to combined gastrointestinal continuity restoration and complex abdominal wall reconstruction after Hartmann's procedure complicated by large midline and parastomal hernias. Methods A robotic Hartmann reversal is performed, followed by robotic retromuscular abdominal wall reconstruction of all ventral defects with bilateral posterior component separation using the double‐docking approach. Surgical steps are thoroughly described, and the accompanying video highlights critical steps of the procedure, anatomical landmarks and technical details relevant to successful completion. Results Complete restoration of the anatomy was achieved with an operative time of 6.5 h. Mobilization occured on day 1, and bowels were opened on day 3. Surgical discharge was possible on day 5. No intra‐operative surgical complication occurred and follow‐up at 6 months showed no recurrence or mid‐term complication. Conclusion Combined minimally invasive reconstruction of the gastrointestinal tract and abdominal wall was feasible using a robotic system. In addition, potential advantages of postoperative rehabilitation and reduced surgical site complications are suggested. Prospective evaluation of the technique is ongoing.
ISSN:1462-8910
1463-1318
DOI:10.1111/codi.16583