Robotic-assisted colorectal procedures in a gynecologic oncology setting

Purpose: Despite potential benefits, gynecologic oncology has not fully embraced use of the robot for concomitant colorectal procedures. The authors describe the robotic technique and outcomes of colorectal surgeries from an experienced gynecologic oncologist's practice. Materials and Methods: A review of robotic-assisted gynecologic surgeries between 2011 and 2016 was undertaken to identify patients with colorectal procedures and findings. Results: Sixteen patients had robotic-assisted colorectal procedures, including end-sigmoid colostomy (n=8), colon resection with anastomosis (n=5), low anterior resection with end-to-end anastomosis (n=3), and cecectomy (n=1). Median operative time was 130 minutes, blood loss 50 ml, and length-of-stay three days. There were no intra-operative complications or conversions. One postoperative ileus resolved with supportive care and one intermittent partial bowel obstruction not requiring hospitalization occurred. Conclusions: Robotic-assisted colorectal procedures by a gynecologic oncologist can be done safely and in reasonable operative time. Gynecologic oncology calls for overlapping training in multiple domains with a minimally invasive approach.