PMC5059363_01
Port sites of daVinci  robot-assisted low anterior resection of the rectum and laparoscopic radical prostatectomy. Asterisk Right lateral 8-mm port below the umbilicus which was used to 12-mm trocar for introduction of endo-GIA during robotic assisted low anterior resection. For robot-assisted laparoscopic radical prostatectomy, 8-mm working arm was reinserted with secure suture to prevent CO2 leakage. Hash The extraction site of both specimens which was closed once after robotic assisted LAR and 12-mm trocar was replaced for robot-assisted laparoscopic radical prostatectomy
40064_2016_3456_Fig1_HTML.jpg
PMC5059363_01_40064_2016_3456_Fig1_HTML.jpg
Fig1
The 11-mm trocar was placed in the right midabdomen cephalad and lateral to the umbilicus in the anterior axillary line to allow assistant access for mobilization of the left colon (Fig. 1).  Then two additional ports were placed (Fig. 1).
Surgical procedures of the daVinci robot-assisted low anterior resection of the rectum and laparoscopic radical prostatectomy. a Posterior dissection in the pelvic cavity using four robotic arms, b anterior dissection in the pelvic cavity using four robotic arms, c after daVinci robot-assisted low anterior resection of the rectum, d daVinci  robot-assist laparoscopic radical prostatectomy
40064_2016_3456_Fig2_HTML.jpg
PMC5059363_01_40064_2016_3456_Fig2_HTML.jpg
Fig2
At the level of the fourth sacral vertebra, the rectosacral ligament was divided sharply to avoid avulsion of the presacral fascia and the fascia propria of the rectum (Fig. 2a). Cadiere grasper. Counter traction was provided by left first robotic arm using the precise  Bipolar grasper (Fig. 2b). The anastomosis was tested with air insufflation (Fig. 2c). Apical dissection and transection of the urethra were next performed (Fig. 2d).