Right Hemicolectomy, Robot-Assisted, with Complete Mesocolic Excision (CME) and UFA (Uncinatus First Approach) (Critical View Concept (CV))

Positioning the patient on their back and padding the extremities as well as pressure-sensitive areas.

Positioning of both patient arms.

Positioning in 10° reverse Trendelenburg and 10° left lateral position, table as low as possible.

To maximize the reduction of positioning injuries and ensure safe positioning, positioning in the vacuum mattress is recommended.

Note: Positioning is particularly important due to the docking of the patient to the robot manipulator. The risk of injury to the abdominal wall when the patient slips must also be considered. With coupled tables in the Xi system, intraoperative position changes are possible without undocking. If the "Table-Motion" technique is not available, the surgical robot must always be undocked and removed from the operating table before any position change.

Caution: Vacuum cushions may have leaks. Therefore, they should be checked again before sterile draping.

Creation of a capnoperitoneum by inserting a Veress needle at Palmer's Point. Marking a line between a point 3-4 cm suprapubic and the left midclavicular line at the costal margin. Marking the trocars. Insertion of robotic trocars along this line. Port 3 should be a 12 mm trocar (stapler port).

Note: In addition to conventional placement, trocar placement along the two anterior superior iliac spines can be performed with cosmetic advantages.

Caution: The trocars should be 8 cm apart and at least 2 cm from the anterior superior iliac spine (ASIS) and the costal margin.

A 12 mm assistant trocar is placed in the left mid-abdomen between and lateral to 2 and 3. Positioning in 10° anti-Trendelenburg and 10° left lateral position.

Docking of the camera arm. Targeting maneuver. Docking of the other arms. Insertion of the instruments.

Trocars for 2 "left hands"

1: Cardiere or Tip Up

2: Bipolar Forceps

3: Camera/Linear stapler

4: Scissors/Vessel sealer/Needle holder

Caution: The trocars must be positioned with the wide black ring (Remote Center) at the level of the muscular abdominal wall. This ensures minimal shear movements.

Note: Inspection of the robotic trocars with the camera via the assistant trocar during the insertion of robotic instruments. This allows easy verification of the position of all robotic trocars before the start of the operation.