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A novel approach of robotic-assisted anterior resection with transanal or transvaginal retrieval of the specimen for colorectal cancer
Surgical Endoscopy, 05/20/09

Choi GS et al. - In a study to assess use of a surgical robot (da Vinci S) for laparoscopic surgery to perform a totally intracorporeal resection of the rectum and colorectal anastomosis, with transanal or transvaginal retrieval of specimens, it appears that robotic-assisted laparoscopic methods were safe for anterior resection (AR) in pts with colorectal cancer. This approach made it easier to perform a total mesorectal excision, anastomosis, and closure of the vaginal wall, and avoided the traditional abdominal incision.

• Data were collected on 13 pts who underwent robot-assisted rectal surgery by a single surgeon.
• For low anterior resection (LAR), the splenic flexure was mobilized laparoscopically, followed by robotic rectal resection and anastomosis, and transanal removal of specimens in both male and female pts.
• The specimen was retreived through the vagina in some female pts.

• 11 and 2 pts underwent LAR and AR, respectively.
• Mean operative time was 260.8 ± 62.9 min with median robotic time of 118 ± 43.6 min.
• There were 3 postoperative complications, in 2 pts.
• 1 pt had anastomotic bleeding and the other had anastomotic leakage following inferior mesenteric artery bleeding.
• Circumferential margins were clear.
• Tumor stage was I in 4, II in 2, and III in 7 pts.
• In 1 pt, the distal resection margin was involved.
• Pts resumed an oral diet and were discharged on the third and seventh day after surgery.

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