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SurgeryU: Master Course: Koh Multi-Site Robotically-Assisted Laparoscopy

Presented by Thomas Payne

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The Koh technique is utilized with multiple ports on the robotic platform. A uterine manipulator with a pneumo-occluder balloon is placed to initiate procedure. Ports are arranged 8-10 cm apart in an arch configuration. The first assistant skill set to facilitate the procedure is emphasized. Bipolar and monopolar instruments are used to release the lateral attachments and for creation of the bladder flap. Anterior and posterior colpotomies are created early, avoiding the uterine arteries. The uterine arteries are taken down at the end of the procedure from the lateral view. Aggressive cephalad pressure on the uterine manipulator is maintained throughout the case.

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