Endoscopic submucosal dissection transanal hybrid laparoendoscopic robot-assisted

We present a new approach for rectal polyps that are not resectable endoscopically.

To resect a postanal polyp extending laterally 8 cm (LST-G), we used the da Vinci® Xi™, a UNI-VEC® transanal device, and an Olympus® Endoscope. With the patient in prone position, saline is injected in the submucosal plane, followed by the mucosal incision and hydrodissection performed with a HybridKnife® scalpel. The arms of the robotic platform allow for better traction, coagulation, and suturing. Endoscopic dissection using the retroflexed view facilitates critical viewing of the posterior region. This procedure enabled us to completely resect a 7 × 3.5 cm lesion in 90 min.