Total Transvaginal Right Hemicolectomy Using Single-Port Robotic Platform - A Novel CadavericTech

Introduction: Advances in robotic technology and natural orifice transluminal endoscopic surgery (NOTES) have created opportunities for truly scarless abdominal procedures. We describe a novel technique of total transvaginal right hemicolectomy using a single-port robotic platform in a cadaver model, highlighting technical feasibility and future clinical potential.

Methods: A fresh female cadaver was positioned in lithotomy. A transvaginal colpotomy was created to introduce the single-port robotic access platform. Using standard oncologic principles, a complete right hemicolectomy was performed. Key steps included mobilization of the terminal ileum, cecum, and ascending colon; vascular ligation of the ileocolic and right colic pedicles; and intracorporeal resection. Specimen removal was achieved entirely through the vaginal access without the need for any abdominal incision. The anastomosis was performed intracorporeally with robotic assistance.

Results: The procedure was completed successfully without intraoperative complications or the need for auxiliary abdominal trocars. Adequate mobilization, vascular control, and oncologic resection margins were achieved. Visualization and triangulation were maintained through the single-port robotic platform. This proof-of-concept demonstrated the feasibility of a completely transvaginal colectomy, eliminating the requirement for abdominal extraction sites.

Conclusion: This cadaveric study establishes the technical feasibility of a total transvaginal right hemicolectomy using a single-port robotic system. As a novel approach, it represents the next step toward scarless colorectal surgery, with potential advantages in reducing abdominal wall trauma, postoperative pain, and hernia risk. Further clinical validation is required to assess safety, patient selection, and long-term outcomes, but this technique may signal the future of natural orifice robotic colectomy.