Clin Colon Rectal Surg 2015; 28(03): 152-157
DOI: 10.1055/s-0035-1558823
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Emerging and Evolving Technology in Colon and Rectal Surgery

Raul M. Bosio
1   Division of Colon and Rectal Surgery, Department of Surgery, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
,
Alessio Pigazzi
2   Division of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine, Orange, California
› Author Affiliations
Further Information

Publication History

Publication Date:
05 October 2015 (online)

Abstract

Minimally invasive surgery has changed the way we manage many colon and rectal pathologies. Multiple techniques, from straight laparoscopic procedures, to hand-assisted and single-port techniques are available, requiring surgeons to go through various learning curves. Robotic surgery is a relatively novel technique in general surgery which appears to hold most promise for rectal resection. Laparoscopic rectal procedures are difficult, and even in experienced hands, conversion rates are around 17%. Robotic surgery may be a point of difference in these cases, despite a long learning curve and higher costs. This article will describe the role of robotics in colorectal surgery. Room set up, port placement, and docking strategies will be described for common procedures, with emphasis on a hybrid robotic low anterior resection.

 
  • 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 (20) 2050-2059
  • 2 Buunen M, Veldkamp R, Hop WC , et al; Colon Cancer Laparoscopic or Open Resection Study Group. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 2009; 10 (1) 44-52
  • 3 Veldkamp R, Kuhry E, Hop WC , et al; 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 (7) 477-484
  • 4 Jayne DG, Guillou PJ, Thorpe H , et al; UK MRC CLASICC Trial Group. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 2007; 25 (21) 3061-3068
  • 5 Jayne DG, Thorpe HC, Copeland J, Quirke P, Brown JM, Guillou PJ. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 2010; 97 (11) 1638-1645
  • 6 van der Pas MH, Haglind E, Cuesta MA , et al; COlorectal cancer Laparoscopic or Open Resection II (COLOR II) Study Group. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol 2013; 14 (3) 210-218
  • 7 Kang CY, Chaudhry OO, Halabi WJ , et al. Outcomes of laparoscopic colorectal surgery: data from the Nationwide Inpatient Sample 2009. Am J Surg 2012; 204 (6) 952-957
  • 8 Monson JR, Weiser MR, Buie WD , et al; Standards Practice Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the management of rectal cancer (revised). Dis Colon Rectum 2013; 56 (5) 535-550
  • 9 Fleshman J, Marcello P, Stamos MJ, Wexner SD ; American Society of Colon and Rectal Surgeons (ASCRS); Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Focus Group on Laparoscopic Colectomy Education as endorsed by The American Society of Colon and Rectal Surgeons (ASCRS) and The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Dis Colon Rectum 2006; 49 (7) 945-949
  • 10 Dalton RS, Smart NJ, Edwards TJ, Chandler I, Daniels IR. Short-term outcomes of the prone perineal approach for extra-levator abdomino-perineal excision (elAPE). Surgeon 2012; 10 (6) 342-346
  • 11 Baik SH, Ko YT, Kang CM , et al. Robotic tumor-specific mesorectal excision of rectal cancer: short-term outcome of a pilot randomized trial. Surg Endosc 2008; 22 (7) 1601-1608
  • 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 (10) 1521-1525
  • 13 Bianchi PP, Luca F, Petz W , et al. The role of the robotic technique in minimally invasive surgery in rectal cancer. Ecancermedicalscience 2013; 7: 357
  • 14 Ahmed K, Khan MS, Vats A , et al. Current status of robotic assisted pelvic surgery and future developments. Int J Surg 2009; 7 (5) 431-440
  • 15 Halabi WJ, Kang CY, Jafari MD , et al. Robotic-assisted colorectal surgery in the United States: a nationwide analysis of trends and outcomes. World J Surg 2013; 37 (12) 2782-2790
  • 16 Lin S, Jiang HG, Chen ZH, Zhou SY, Liu XS, Yu JR. Meta-analysis of robotic and laparoscopic surgery for treatment of rectal cancer. World J Gastroenterol 2011; 17 (47) 5214-5220
  • 17 Memon S, Heriot AG, Murphy DG, Bressel M, Lynch AC. Robotic versus laparoscopic proctectomy for rectal cancer: a meta-analysis. Ann Surg Oncol 2012; 19 (7) 2095-2101
  • 18 Yang Y, Wang F, Zhang P , et al. Robot-assisted versus conventional laparoscopic surgery for colorectal disease, focusing on rectal cancer: a meta-analysis. Ann Surg Oncol 2012; 19 (12) 3727-3736
  • 19 Collinson FJ, Jayne DG, Pigazzi A , et al. An international, multicentre, prospective, randomised, controlled, unblinded, parallel-group trial of robotic-assisted versus standard laparoscopic surgery for the curative treatment of rectal cancer. Int J Colorectal Dis 2012; 27 (2) 233-241
  • 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 (2) 123-126
  • 21 Hellan M, Stein H, Pigazzi A. Totally robotic low anterior resection with total mesorectal excision and splenic flexure mobilization. Surg Endosc 2009; 23 (2) 447-451
  • 22 Park YA, Kim JM, Kim SA , et al. Totally robotic surgery for rectal cancer: from splenic flexure to pelvic floor in one setup. Surg Endosc 2010; 24 (3) 715-720