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Combined robotic transanal total mesorectal excision (R-taTME) and single-site plus one-port (R-SSPO) technique for ultra-low rectal surgery—initial experience with a new operation approach

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objective

Robot-assisted rectal surgery is gaining popularity, and robotic single-site surgery is also being explored clinically. We report our initial experience with robotic transanal total mesorectal excision (R-taTME) and radical proctectomy using the robotic single-site plus one-port (R-SSPO) technique for low rectal surgery.

Methods

Between July 2015 and March 2016, 15 consecutive patients with ultra-low rectal lesions underwent R-taTME followed by radical proctectomy using the R-SSPO technique by a single surgeon. The clinical and pathological results were retrospectively analyzed.

Results

The median operative time was 473 (range, 335–569) min, and the estimated blood loss was 33 (range, 30–50) mL. The median number of lymph nodes harvested was 12 (range, 8–18). The median distal resection margin was 1.4 (range, 0.4–3.5) cm, and all patients had clear circumferential resection margins. We encountered a left ureteric transection intraoperatively in one patient, and another patient required reoperation for postoperative adhesive intestinal obstruction. There was no 30-day mortality.

Conclusion

R-taTME followed by radical proctectomy using the R-SSPO technique for patients with low rectal lesions is technically feasible and safe without compromising oncologic outcomes. However, there were considerable limitations and a steep learning curve using current robotic technology.

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Authors and Affiliations

  1. Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, 252 Wuxing Street, Sinyi District, Taipei, 11031, Taiwan

    Li-Jen Kuo

  2. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Li-Jen Kuo

  3. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Li-Jen Kuo

  4. Department of Surgery, Changi General Hospital, Singapore, Singapore

    James Chi-Yong Ngu

  5. Division of Acute Care Surgery and Traumatology, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan

    Yiu-Shun Tong & Chia-Che Chen

Authors
  1. Li-Jen Kuo
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  2. James Chi-Yong Ngu
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  3. Yiu-Shun Tong
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  4. Chia-Che Chen
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Correspondence to Li-Jen Kuo.

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The authors declare that they have no conflicts of interest.

Additional information

Li-Jen Kuo and James Chi-Yong Ngu contributed equally to this work.

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Kuo, LJ., Ngu, J.CY., Tong, YS. et al. Combined robotic transanal total mesorectal excision (R-taTME) and single-site plus one-port (R-SSPO) technique for ultra-low rectal surgery—initial experience with a new operation approach. Int J Colorectal Dis 32, 249–254 (2017). https://doi.org/10.1007/s00384-016-2686-3

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  • DOI: https://doi.org/10.1007/s00384-016-2686-3

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