Abstract
Splenic flexure mobilization is a controversial issue during sigmoidectomy or anterior resection of the rectum. In the literature, it is not clear whether it is necessary to perform it routinely, nor is there a clear consensus regarding how to do it. Some surgeons would advocate performing this procedure only in selected cases, if there is no redundancy of the sigmoid colon or if the anastomosis will be in the upper rectum. Others would rather prefer to perform it systematically in order to standardize the procedure and gain experience. Similarly, its performance laparoscopically or robotically depends again on the preference of the surgeon, since to date it has not been shown in the literature whether one approach or another provides benefits for the patient or the surgeon. In this chapter we present our approach to this procedure as well as the step-by-step surgical technique for mobilizing the splenic flexure performed from medial to lateral with a robotic approach.
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References
Marsden MR, Conti JA, Zeidan S, Flashman KG, Khan JS, O’Leary DP, et al. The selective use of splenic flexure mobilization is safe in both laparoscopic and open anterior resections. Colorectal Dis. 2012;14(10):1255–61.
Jamali FR, Soweid AM, Dimassi H, Bailey C, Leroy J, Marescaux J. Evaluating the degree of difficulty of laparoscopic colorectal surgery. Arch Surg. 2008;143(8):762–7; discussion 8.
Kumamoto T, Shinohara H, Tomizawa K, Hanaoka Y, Toda S, Takemura N, et al. Inferior pancreatic approach for laparoscopic splenic flexure mobilization. Tech Coloproctol. 2018;22(1):71–2.
Chand M, Miskovic D, Parvaiz AC. Is splenic flexure mobilization necessary in laparoscopic anterior resection? Dis Colon Rectum. 2012;55(11):1195–7.
Hiranyakas A, Da Silva G, Denoya P, Shawki S, Wexner SD. Colorectal anastomotic stricture: is it associated with inadequate colonic mobilization? Tech Coloproctol. 2013;17(4):371–5.
Mouw TJ, King C, Ashcraft JH, Valentino JD, DiPasco PJ, Al-Kasspooles M. Routine splenic flexure mobilization may increase compliance with pathological quality metrics in patients undergoing low anterior resection. Colorectal Dis. 2019;21(1):23-9
Pai A, Marecik S, Park J, Prasad L. Robotic colorectal surgery for neoplasia. Surg Clin North Am. 2017;97(3):561–72.
Da Vinci X/Xi Instrument & Accessory Catalog. 2020.
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Fernandez, C.C., Ruiz, M.G., Poch, L.C., Suarez Pazos, N. (2022). Robotic Splenic Flexure Mobilization. In: Coyne, P., Khan, J. (eds) Robotic Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-15198-9_17
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DOI: https://doi.org/10.1007/978-3-031-15198-9_17
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