Single-Stage Totally Robotic Dissection for Rectal Cancer Surgery: Technique and Short-Term Outcome in 50 Consecutive Patients
- Choi, Dong Jin; Kim, Seon Hahn; Lee, Peter J. M.; Kim, Jin; Woo, Si Uk
- Issue Date
- LIPPINCOTT WILLIAMS & WILKINS
- Robotics; Rectal cancer; Rectal surgery
- DISEASES OF THE COLON & RECTUM, v.52, no.11, pp.1824 - 1830
- Journal Title
- DISEASES OF THE COLON & RECTUM
- Start Page
- End Page
- PURPOSE: To overcome the pitfalls of laparoscopy, a robotic system has been introduced in rectal cancer surgery. However, there is no standard procedure to maximize the advantages of the da Vinci(R) S Surgical System. Therefore, we describe our technique of applying the robotic system during all of the steps of dissection in rectal cancer surgery and the short-term outcome. METHODS: Prospectively collected data were reviewed from 50 consecutive patients who underwent single-stage, totally robotic dissection for rectal cancer resection between July 2007 and June 2008. Robotic dissection was performed following these steps: 1) ligation of the inferior mesenteric vessels and medial to lateral dissection, 2) mobilization of the sigmoid/descending/splenic flexure colon, and 3) rectal dissection. The remaining steps including rectal transection and anastomosis were performed by a conventional laparoscopic method. RESULTS: There were 32 (64%) men and 18 (36%) women. The mean distance from the anal verge to the tumor margin was 7.3 (range, 2-13) cm. The conversion rate was 0%. The mean operative time was 304.8 (range, 190-485) minutes, and 20.6 (range, 6-48) lymph nodes were harvested. The circumferential margin was positive in one patient. The length of hospital stay after surgery was 9.2 (range, 5-24) days. Anastomotic leak rate was 8.3%, and all of the patients with leakage were managed conservatively. CONCLUSIONS: Single-stage robotic dissection for rectal cancer surgery is feasible, and its short-term outcome is acceptable. Our technique can be a suitable procedure to maximize the advantages of the da Vinci(R) system.
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- 2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles
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