Combined robotic transanal total mesorectal excision (R-taTME) and single-site plus one-port (R-SSPO) technique for ultra-low rectal surgery—initial experience with a new operation approach

Objective Robot-assisted rectal surgery is gaining popularity, and robotic single-site surgery is also being explored clinically. We report our initial experience with robotic transanal total mesorectal excision (R-taTME) and radical proctectomy using the robotic single-site plus one-port (R-SSPO) t...

Full description

Saved in:
Bibliographic Details
Published in:International journal of colorectal disease 2017-02, Vol.32 (2), p.249-254
Main Authors: Kuo, Li-Jen, Ngu, James Chi-Yong, Tong, Yiu-Shun, Chen, Chia-Che
Format: Article
Language:English
Subjects:
Adult
Aged
Anal Canal - surgery
Demography
Digestive System Surgical Procedures - methods
Female
Gastroenterology
Hepatology
Humans
Internal Medicine
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Proctology
Rectum - surgery
Robotics
Surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective Robot-assisted rectal surgery is gaining popularity, and robotic single-site surgery is also being explored clinically. We report our initial experience with robotic transanal total mesorectal excision (R-taTME) and radical proctectomy using the robotic single-site plus one-port (R-SSPO) technique for low rectal surgery. Methods Between July 2015 and March 2016, 15 consecutive patients with ultra-low rectal lesions underwent R-taTME followed by radical proctectomy using the R-SSPO technique by a single surgeon. The clinical and pathological results were retrospectively analyzed. Results The median operative time was 473 (range, 335–569) min, and the estimated blood loss was 33 (range, 30–50) mL. The median number of lymph nodes harvested was 12 (range, 8–18). The median distal resection margin was 1.4 (range, 0.4–3.5) cm, and all patients had clear circumferential resection margins. We encountered a left ureteric transection intraoperatively in one patient, and another patient required reoperation for postoperative adhesive intestinal obstruction. There was no 30-day mortality. Conclusion R-taTME followed by radical proctectomy using the R-SSPO technique for patients with low rectal lesions is technically feasible and safe without compromising oncologic outcomes. However, there were considerable limitations and a steep learning curve using current robotic technology.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-016-2686-3