Design: Demonstration of robotic-assisted laparoscopic surgical techniques with narrated video footage.

Setting: The patient is positioned in dorsal lithotomy with steep Trendelenberg in the operative room.

Patients or Participants: One patient with stage IV adenocarcinoma of the splenic flexure who presents for surgical work up of enlarging left adnexal mass on CT.

Interventions: Robotic-assisted laparoscopic removal of bilateral tubes and ovaries, pelvic side wall dissection.

Measurements and Main Results: N/A

Conclusion: In patients with advanced gastrointestinal carcinoma, pelvic side wall dissection is often necessary to identify iliac vessels and ureters. Knowledge of anatomic landmarks, careful tissue handling, judicious use of cautery and careful hemostasis may allow for safe and efficient removal of bilateral tubes and ovaries in a patient with GI carcinoma.