Utility of Visceral Organ Hanging Maneuver (VOHM) for Exposure and Stabilization of the Operative Field in Robotic Abdominal Surgery

Background: In laparoscopic surgery, hanging techniques have been described in attempt to reduce the number of ports and to guide surgery. However, with the fixed robotic surgical platform, we saw its use for different purposes. We called our technique a "visceral organ hanging maneuver (VOHM)" and have utilized it to expose and stabilize the field, to allow for maximal utilization of the robotic arms, and to mark the bowel resection margins. Objective: The present study was demonstrated the VOHM technique for a variety of reasons on different organs. Material and Method: A retrospectively reviewed our recorded videos of robotic abdominal surgery between July 2010 and September 2016. We used the da Vinci Si Robotic System (Intuitive Surgical Inc. Sunny Vale, Calif). Results: VOHM is a simple technique to suspend various organs to improve the exposure, stabilize the operative field, and guide the resection. Conclusion: VOHM technique was created not only to provide a widely exposed and stable operative field so the surgeon could concentrate on the work, but also to free up an instrument that would otherwise be used as a fixed retractor. The technique allows for an efficient, safe, and oncologically acceptable bowel resection in case of malignancy.