Igor Monsellato*, Alessia Morello, Paola Franzone, Gianmauro Numico and Fabio Priora
SS Antonio and Biagio and Cesare Arrigo Hospital, Alessandria, ItalyFulltext PDF
Introduction: Robotic transanal surgery is a newer approach to rectal dissection whose purpose is to overcome the limits of the traditional transabdominal approach, improving accuracy of distal dissection and preservation of hypogastric innervation. An increasing interest on this new technique has raised, thanks to the excellent pathological and acceptable short-term clinical outcomes reported.
Materials and Methods: Three consecutive cases of robotic transanal TME were prospectically performed between May 2017 and October 2017. Neoadjuvant treatment was indicated after multidisciplinary board and consisted in long-course radiotherapy of 50.4 Gy associated with oral capecitabine, according to the international guidelines.
Results: TME quality was Quirke 3 grade in all cases. Mean operative time was 530 mins. A handsewn coloanal anastomosis was performed and a loop ileostomy was also fashioned in all three patients. None of the patients had intra-operatively or post-operatively complications.
Conclusion: Robotic transanal TME is a very recent procedure. Few reports are still available to draw final conclusions, but preliminary results have shown that is feasible and safe with good technical and oncological results. Robotic assistance confirmed its advantages, which are enhanced performing this type of procedure (endowrist, scaled motion, magnified and 3D vision). Acclaimed greatest advantage of robotic transanal TME is the facilitation of dissection with an in-line view, which translates in an improved surgical field exposure and visualization. Further investigations are needed to assure the actual value of robotic transanal approach.
Robotic Transanal Surgery; Rectal Surgery; TME; Minimally-Invasive Surgery; Rectal Cancer
Monsellato I, Morello A, Franzone P, Numico G, Priora F. Robotic Transanal Total Mesorectal Excision: A New Perspective for Low Rectal Cancer Treatment. Clin Surg. 2019; 4: 2362.