title: Three-step standardized approach for complete mobilization of the splenic flexure during robotic rectal cancer surgery.
abstract: OBJECTIVE
  The aim of this technical note is to describe a three-step technique for expeditious and complete mobilization of the splenic flexure (CMSF) during single docking totally robotic rectal cancer surgery.
  
  
  METHODS
  A prospectively maintained database was searched for all patients who underwent single docking totally robotic rectal cancer surgery with CMSF through a stepwise technique.
  
  
  RESULTS
  We studied 89 patients underwent CMSF during single docking totally robotic lower anterior resection for rectal cancer.
  
  
  CONCLUSIONS
  The technique demonstrates that CMSF can be performed with a standardized approach using the natural embryological planes of surgery. Moreover, this technique does not involve any change in patient's position on the operating table or undocking the robotic system. We have included an intra-operative video recording to demonstrate the technique.
authors.affiliation: Minimally Invasive Colorectal Unit (MICU), Department of Colorectal Surgery, Queen Alexandra Hospital NHS Trust, Portsmouth, UK.
authors.forename: J
authors.initials: J
authors.lastname: Ahmed
authors.affiliation: Department of Surgery, Ankara University Medical School, Ankara, Turkey.
authors.forename: M A
authors.initials: MA
authors.lastname: Kuzu
authors.affiliation: Digestive Cancer Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.
authors.forename: N
authors.initials: N
authors.lastname: Figueiredo
authors.affiliation: Minimally Invasive Colorectal Unit (MICU), Department of Colorectal Surgery, Queen Alexandra Hospital NHS Trust, Portsmouth, UK.
authors.forename: J
authors.initials: J
authors.lastname: Khan
authors.affiliation: Minimally Invasive Colorectal Unit (MICU), Department of Colorectal Surgery, Queen Alexandra Hospital NHS Trust, Portsmouth, UK.|Digestive Cancer Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Parvaiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044684:Colon, Transverse / Q000601:surgery*; D016208:Databases, Factual; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000379:methods*
keywords: Colorectal cancer; education; flexure mobilization; robotic surgery