This operative video demonstrates a robotic right hemicolectomy with intracorporeal enterocolic anastomosisperformed for cecal adenocarcinoma.

The patient is a 95-year-old woman who presented with symptoms of bowel obstruction and was found on colonoscopy to have a nearly obstructing cecal mass. Endoscopic biopsy was non-diagnostic. Staging evaluation demonstrated a CEA of 3.1 with no radiographic evidence of distant metastatic disease.

The patient underwent robotic staging laparoscopy followed by robotic right hemicolectomy. Intraoperative indocyanine green (ICG) angiography was used to assess perfusion of the bowel prior to reconstruction. An intracorporeal side-to-side enterocolic anastomosis was performed using minimally invasive techniques.

Final pathology demonstrated:

• pT3 pN2b poorly differentiated adenocarcinoma

• 8 of 14 lymph nodes involved with carcinoma

• Negative surgical margins

The patient recovered well following surgery and was discharged home on postoperative day four.

This case illustrates the application of robotic minimally invasive colorectal surgery in elderly patients with obstructing colon cancer, demonstrating safe oncologic resection and intracorporeal reconstruction.