Pelvis from “hell”: feasibility of robotic assistance in TME in difficult pelvis

P.C. Giulianotti SUMMARY: The pneumoperitoneum is induced with the Verres needle. The abdominal exploration does not show carcinomatosis and liver metastases. An extensive adhesiolysis till complete exposition of the hepatic hilum is carried out laparoscopically and robotically. Identification and preparation of the jejuanl limb anastomosed with the pancreas and the common bile duct (the patient has undergone a Whipple procedure and developed a biliary stenosis). The bilio-enteric anastomosis is taken down and sent for frozen section (negative for malignancy). The termino-laterl hepaticojejunostomy is completed with PDS 4.0 – posterior running and anterior interrupted suture -.