Novel Technique of Robotic Extralevator Abdominoperineal Resection with Gracilis Flap Closure

Michelle Sieffert, James R. Ouellette, Ron Michael Johnson, Todd Hicks, Minia Hellan

Research output: Contribution to journalArticlepeer-review

Abstract

<p> <h4> BACKGROUND: </h4></p><p> The purpose of this paper is to introduce a robotic assisted approach to extralevator abdominoperineal excision in the modified Lloyd-Davis position with reconstruction of the perineum using pedicled gracilis flaps, and to discuss outcomes in a cohort of six patients. <h4> METHODS: </h4></p><p> Data was collected by chart review on six patients who underwent extralevator excision with gracilis flap reconstruction from 10/2013 to 06/2015. Technical details, operative data, oncologic outcomes, and wound healing complications were evaluated. <h4> RESULTS: </h4></p><p> There were no instances of intraoperative perforation or positive circumferential resection margin, and one case of locoregional recurrence. Two patients experienced flap venous congestion and one patient developed a perineal abscess. All patients went on to complete healing. <h4> CONCLUSIONS: </h4></p><p> The combination of a minimally invasive robotic assisted extralevator abdominoperineal excision performed in the modified Lloyd-Davis position with reconstruction of the perineum with pedicled gracilis flaps has excellent oncologic outcomes and acceptable wound healing complications. Copyright &copy; 2016 John Wiley &amp; Sons, Ltd. StartCopTextCopyright &copy; 2016 John Wiley &amp; Sons, Ltd.</p><p> Copyright &copy; 2016 John Wiley &amp; Sons, Ltd.</p>
Original languageAmerican English
JournalThe International Journal of Medical Robotics and Computer Assisted Technology
Volume13
DOIs
StatePublished - Sep 1 2017

Keywords

  • ELAPE
  • extralevator APR
  • extralevator abdominoperineal resection
  • gracilis flap
  • pedicled gracilis flap
  • perineal reconstruction
  • robotic-assisted

Disciplines

  • Medical Specialties
  • Medicine and Health Sciences
  • Surgery

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