V82 - Single-Docking Robotic Subtotal Colectomy with End Ileostomy

Saturday, May 9, 2026

On-Demand

Video Presentation(s)

Yun Hwa W. Wang, MD

Fellow Physician
Penn State Hershey Medical Center
Penn State Hershey Medical Center
Hershey, PA, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

Author(s)

AP

Abdul Wasay A. Paracha, n/a

Medical Student
Penn State College of Medicine
Hershey, Pennsylvania, United States

Disclosure information not submitted.
HC

Heather Carmichael, MD

Assistant Professor
Department of Surgery, Division of Colon and Rectal Surgery
Hershey, Pennsylvania, United States

Disclosure information not submitted.
AK

Audrey S. Kulaylat, MD MSc

Assistant Professor
Penn State Health
Hershey, Pennsylvania, United States

Disclosure information not submitted.
JS

Jeffrey S. Scow, MD, FACS, FASCRS

Associate Professor of Surgery
Milton S. Hershey Medical Center, Penn State Health
Hershey, Pennsylvania, United States

Disclosure information not submitted.

Senior Author(s)

PL

Patricio B. Lynn, MD

Assistant Professor of Surgery
Penn State University
Hummelstown, Pennsylvania, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

CME Eligible

Purpose/Background: Robotic surgery has revolutionized minimally invasive surgery, especially in colon and rectal surgery. Robotic docking, however, remains a challenge when working in multiple quadrants of the abdomen, as in cases of subtotal or total abdominal colectomies. This often necessitates un-docking, re-docking, rotation of the boom with re-targeting of the robot in various steps of the procedure. We present a case demonstrating our technique of robotic subtotal colectomy for treatment of ulcerative colitis using a single docking approach.

Methods/Interventions: DaVinci Xi robotic system was used for this operation. Targeting was performed onto the transverse colon using upper abdominal setting. Camera was placed in arm number three (8-mm), with arms number one (8-mm), two (12-mm), and four (8-mm) as the working ports. 12-mm port was placed at site of planned ileostomy, which was marked pre-operatively by wound ostomy nurses. 5-mm bedside assistant port was placed in right upper quadrant.

Results/Outcomes: Total operative time was 246 minutes. Estimated blood loss 40ml. Final specimen extracted through 12-mm port site with no additional incisions and end ileostomy matured at this site. Patient with unremarkable post-operative course and was discharged on day 4.

Conclusion/Discussion: Single-docking technique of subtotal colectomy is feasible in select patients. Initial dissection of sigmoid colon may be challenging given proximity of the sigmoid colon to the working ports, this can be overcome with proper bedside assistance. Targeting to the transverse colon allows an ideal exposure for the most challenging part of the case.