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ROBOTIC TOTAL PROCTOCOLECTOMY, END ILEOSTOMY, AND OMENTAL PEDICLE FLAP
Peter J. Davis*, Scott Kelley, Kevin Behm
Mayo Clinic, Rochester, MN

Robotic total proctocolectomy with end ileostomy and omental pedicle flap was performed for medically refractory Crohn's proctocolitis and associated anovaginal fistula. Key technical aspects of the procedure include mobilization of the omentum, creation of a left-sided omental pedicle flap, total colonic mobilization and mesenteric division, proctectomy, trans-anal specimen extraction, and pelvic exclusion. Two separate docks of the robot are required for dissection in the abdomen, then pelvis. This approach allows a complex multi-quadrant resection and reconstruction to be performed through an incision-less approach, and can be performed safely and effectively in appropriate candidates.


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