The proposed video-vignette represents a later step towards a truly robotically surgical approach, that combines oncological radicality and preservation of optimal blood flow during a sigmoidectomy for cancer. This totally robotic vessel-sparing approach doesn’t result in longer operative times, higher blood loss or extended length of hospitalization.

During this procedure, before and after anastomosis fashioning, an Indocyanine Green (ICG) test is performed to evaluate adequate perfusion of the colon. This completely robotic approach with IMA, IMV and LCA preservation and robotically sewn anastomosis, does not result in longer operative times, increased blood loss or prolonged hospitalization.

However, it should be noted that we embarked on this approach after fully completing our robotic learning curve. Finally, we offer a word of caution: special situations including formation of enteric fistulas or post-operative hemorrhage, require referral to a high-volume center with both endoscopic and surgical expertise.

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