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Minimally Invasive Coloproctology pp 103–115Cite as

Robotic Rectal Surgery

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Abstract

Laparoscopic surgery for rectal cancer is technically challenging because of the confined space within the pelvis. The da Vinci robotic surgical system is introduced to overcome the limitations of laparoscopy in terms of visualization and maneuverability, which may theoretically enable surgeons to perform a more precise total mesorectal excision (TME) with better oncologic clearance and autonomic nerve preservation. Despite improvements made since its introduction, the current version of the da Vinci system is still not appropriate for multiquadrant surgery because of the limited range of motion of the robotic arms and the difficulty in moving the bulky robotic cart during surgery. In order to overcome these limitations, special operative approaches have been developed for robotic rectal surgery, which include the hybrid approach and the totally robotic approach. The purpose of this chapter is to briefly discuss the technical steps and the pros and cons of various operative approaches for robotic TME. Our technique of totally robotic single docking TME will also be described.

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References

  1. Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350:2050–9.

    Article  Google Scholar 

  2. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy AM, COlon cancer Laparoscopic or Open Resection Study Group (COLOR). Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6:477–84.

    Article  PubMed  Google Scholar 

  3. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM, MRC CLASICC trial group. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365:1718–26.

    Article  PubMed  Google Scholar 

  4. Bonjer HJ, Hop WC, Nelson H, Sargent DJ, Lacy AM, Castells A, Guillou PJ, Thorpe H, Brown J, Delgado S, Kuhrij E, Haglind E, Pahlman L, Transatlantic Laparoscopically Assisted vs Open Colectomy Trials Study Group. Laparoscopically assisted vs open colectomy for colon cancer: a meta-analysis. Arch Surg. 2007;142:298–303.

    Article  PubMed  Google Scholar 

  5. Ng SS, Lee JF, Yiu RY, Li JC, Hon SS, Mak TW, Leung WW, Leung KL. Long-term oncologic outcomes of laparoscopic versus open surgery for rectal cancer: a pooled analysis of 3 randomized controlled trials. Ann Surg. 2014;259:139–47.

    Article  PubMed  Google Scholar 

  6. Ng SS, Leung KL, Lee JF, Yiu RY, Li JC, Teoh AY, Leung WW. Laparoscopic-assisted versus open abdominoperineal resection for low rectal cancer: a prospective randomized trial. Ann Surg Oncol. 2008;15:2418–25.

    Article  PubMed  Google Scholar 

  7. Ng SS, Lee JF, Yiu RY, Li JC, Hon SS, Mak TW, Ngo DK, Leung WW, Leung KL. Laparoscopic-assisted versus open total mesorectal excision with anal sphincter preservation for mid and low rectal cancer: a prospective, randomized trial. Surg Endosc. 2014;28:297–306.

    Article  PubMed  Google Scholar 

  8. Ng SS, Lee JF, Yiu RY, Li JC, Hon SS. Telerobotic-assisted laparoscopic abdominoperineal resection for low rectal cancer: Report of the first case in Hong Kong and China with an updated literature review. World J Gastroenterol. 2007;13:2514–8.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Kim SH, Kwak JM. Robotic total mesorectal excision: operative technique and review of the literature. Tech Coloproctol. 2013;17 Suppl 1:S47–53.

    Article  PubMed  Google Scholar 

  10. Mak TW, Lee JF, Futaba K, Hon SS, Ngo DK, Ng SS. Robotic surgery for rectal cancer: a systematic review of current practice. World J Gastrointest Oncol. 2014;6:184–93.

    PubMed Central  PubMed  Google Scholar 

  11. Zawadzki M, Velchuru VR, Albalawi SA, Park JJ, Marecik S, Prasad LM. Is hybrid robotic laparoscopic assistance the ideal approach for restorative rectal cancer dissection? Colorectal Dis. 2013;15:1026–32.

    Article  CAS  PubMed  Google Scholar 

  12. Pigazzi A, Ellenhorn JD, Ballantyne GH, Paz IB. Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer. Surg Endosc. 2006;20:1521–5.

    Article  CAS  PubMed  Google Scholar 

  13. Hellan M, Anderson C, Ellenhorn JD, Paz B, Pigazzi A. Short-term outcomes after robotic-assisted total mesorectal excision for rectal cancer. Ann Surg Oncol. 2007;14:3168–73.

    Article  PubMed  Google Scholar 

  14. Park JS, Choi GS, Lim KH, Jang YS, Jun SH. Robotic-assisted versus laparoscopic surgery for low rectal cancer: case-matched analysis of short-term outcomes. Ann Surg Oncol. 2010;17:3195–202.

    Article  PubMed  Google Scholar 

  15. Choi GS, Park IJ, Kang BM, Lim KH, Jun SH. A novel approach of robotic-assisted anterior resection with transanal or transvaginal retrieval of the specimen for colorectal cancer. Surg Endosc. 2009;23:2831–5.

    Article  PubMed  Google Scholar 

  16. Kim IK, Kang J, Park YA, Kim NK, Sohn SK, Lee KY. Is prior laparoscopy experience required for adaptation to robotic rectal surgery? Feasibility of one-step transition from open to robotic surgery. Int J Colorectal Dis. 2014;29:693–9.

    Article  PubMed  Google Scholar 

  17. Park IJ, You YN, Schlette E, Nguyen S, Skibber JM, Rodriguez-Bigas MA, Chang GJ. Reverse-hybrid robotic mesorectal excision for rectal cancer. Dis Colon Rectum. 2012;55:228–33.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Spinoglio G, Summa M, Priora F, Quarati R, Testa S. Robotic colorectal surgery: first 50 cases experience. Dis Colon Rectum. 2008;51:1627–32.

    Article  PubMed  Google Scholar 

  19. Hellan M, Stein H, Pigazzi A. Totally robotic low anterior resection with total mesorectal excision and splenic flexure mobilization. Surg Endosc. 2009;23:447–51.

    Article  PubMed  Google Scholar 

  20. Obias V, Sanchez C, Nam A, Montenegro G, Makhoul R. Totally robotic single-position ‘flip’ arm technique for splenic flexure mobilizations and low anterior resections. Int J Med Robot. 2011;7:123–6.

    Article  PubMed  Google Scholar 

  21. Park YA, Kim JM, Kim SA, Min BS, Kim NK, Sohn SK, Lee KY. Totally robotic surgery for rectal cancer: from splenic flexure to pelvic floor in one setup. Surg Endosc. 2010;24:715–20.

    Article  PubMed  Google Scholar 

  22. Choi DJ, Kim SH, Lee PJ, Kim J, Woo SU. Single-stage totally robotic dissection for rectal cancer surgery: technique and short-term outcome in 50 consecutive patients. Dis Colon Rectum. 2009;52:1824–30.

    Article  PubMed  Google Scholar 

  23. AlAsari S, Min BS. Robotic colorectal surgery: a systematic review. ISRN Surg. 2012;2012:293894.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Min BS. da Vinci low anterior resection dual docking technique: procedure guideline. Sunnyvale: Intuitive Surgical, Inc; 2010.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Colorectal Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Room 64045, 4/F, Lui Che Woo Clinical Sciences Building, Shatin, New Territories, Hong Kong SAR, China

    Simon Siu-Man Ng MBChB, MD, FRCSEd, FACS, FASCRS

Authors
  1. Simon Siu-Man Ng MBChB, MD, FRCSEd, FACS, FASCRS
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Corresponding author

Correspondence to Simon Siu-Man Ng MBChB, MD, FRCSEd, FACS, FASCRS .

Editor information

Editors and Affiliations

  1. Department of Surgery, Matilda International Hospital, HongKong, China

    William C S Meng

  2. Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China

    Hester Y S Cheung

  3. City Medical Center Room 833, 8/F, Office Tower 1, Grand Plaza, Hong Kong, China

    David T Y Lam

  4. Department of Surgery, Prince of Wales Hospital The Chinese University of Hong Kong, Hong Kong, China

    Simon S M Ng

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© 2015 Springer International Publishing Switzerland

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Ng, S.SM. (2015). Robotic Rectal Surgery. In: Meng, W., Cheung, H., Lam, D., Ng, S. (eds) Minimally Invasive Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-319-19698-5_12

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  • DOI: https://doi.org/10.1007/978-3-319-19698-5_12

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19697-8

  • Online ISBN: 978-3-319-19698-5

  • eBook Packages: MedicineMedicine (R0)

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