Intracorporeal overlap anastomosis using the da vinci SP system through a pfannenstiel incision for right-sided colon resection: a standardized technique

Abstract Purpose The da Vinci SP surgical system has been increasingly utilized in colorectal surgery; however, technical standardization of intracorporeal anastomosis for right-sided colon resection using the SP platform remains limited. This report aims to demonstrate our standardized technique for intracorporeal overlap anastomosis using the da Vinci SP system through a Pfannenstiel incision. Methods This video article demonstrates intracorporeal mesenteric dissection and overlap anastomosis using the da Vinci SP system through a Pfannenstiel incision. Because the SP platform lacks robotic energy devices and staplers, mesenteric dissection and stapling are performed using assistant-operated laparoscopic instruments. Adequate surgical field exposure is achieved through careful triangulation between the robotic arms and the assistant’s instruments. During intracorporeal overlap anastomosis, stay sutures are useful for gentle traction to facilitate safe stapler insertion and precise bowel alignment. Results Four patients with right-sided colon cancer underwent this procedure, including two ileocecal resections and two right hemicolectomies with D3 lymphadenectomy. All procedures were completed robotically without conversion. The median operative time was 281.5 min, and the median blood loss was 9 mL. No perioperative complications occurred, and no anastomotic leakage or stricture was observed. Conclusion Intracorporeal overlap anastomosis for right-sided colon cancer using the da Vinci SP system through a Pfannenstiel incision is feasible and reproducible.