Robotic Splenic Flexure and Transverse Colon Resections

Since the 1990s, laparoscopic technique has become a standard approach for several surgical procedures in the field of colorectal surgery. Laparoscopic approach to splenic flexure and transverse colon cancer, however, is still a matter of debate and considered challenging for both anatomical and technical aspects. The relationship with the spleen and the absence of a consensus on the extent of surgery for splenic flexure cancer are two of several aspects that make splenic flexure surgery mostly debated. Robotic technique has overcome some pitfalls of laparoscopy, thanks to its stability of vision, tremor filtering, and fine movements of the robotic arms that can help in better identifying and managing both vascular structures and side organs, thus avoiding splenic and pancreatic injuries. In addition, robotic system can allow a better fashioning of the intracorporeal anastomosis, and the advent of fluorescence is useful to guide dissection and to evaluate the vascularization of the colon. Herein we discuss a standardized approach for robotic splenic flexure resection and transverse colon