Gastrointestinal Oncology

Annals of Surgical Oncology

, Volume 16, Issue 5, pp 1274-1278

Full Robotic Left Colon and Rectal Cancer Resection: Technique and Early Outcome

  • Fabrizio LucaAffiliated withDivision of Abdomino-Pelvic Surgery, European Institute of Oncology Email author 
  • , Sabine CenciarelliAffiliated withDivision of Abdomino-Pelvic Surgery, European Institute of Oncology
  • , Manuela ValvoAffiliated withDivision of Abdomino-Pelvic Surgery, European Institute of Oncology
  • , Simonetta PozziAffiliated withDivision of Abdomino-Pelvic Surgery, European Institute of Oncology
  • , Felice Lo FasoAffiliated withDivision of Abdomino-Pelvic Surgery, European Institute of Oncology
  • , Davide RavizzaAffiliated withDivision of Endoscopy, European Institute of Oncology
  • , Giulia ZampinoAffiliated withDivision of Medical Oncology, European Institute of Oncology
  • , Angelica SonzogniAffiliated withDivision of Pathology, European Institute of Oncology
  • , Roberto BiffiAffiliated withDivision of Abdomino-Pelvic Surgery, European Institute of Oncology

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Abstract

Objective

The technique for robotic resection of the left colon and anterior resection of the rectum with total mesorectal excision is not well defined. In this study we describe a method that standardizes robot and trocar position, and allows for a complete mobilization of the left colon and the rectum, without repositioning of the surgical cart. Outcome and pathology findings are also reported.

Methods

From January 2007 to May 2008 a total of 55 consecutive patients affected by rectal and left colon cancer were operated on, with full robotic technique, using the Da Vinci robot. Data regarding outcome and pathology reports were prospectively collected in a dedicated database.

Results

The following procedures were performed 27 left colectomies, 17 anterior resections, 4 intersphincteric resections, 7 abdominoperineal resections. There were 21 female and 34 male patients with a mean age of 63 ± 9.9 years. Mean operative time was 290 ± 69 minutes, ranging from 164 to 487 min., none were converted to open surgery. The median number of lymph nodes harvested was 18.5 ± 8.3 (range 5-45), and circumferential margin was negative in all cases. Distal margin was 25.15 ± 12.9 mm (range 6-55) for patients with rectal cancer, and 31.6 ± 20 mm for all the patients in this series. Anastomotic leak rate was 12.7% (7/55); in all cases conservative treatment was successful.

Conclusions

Full robotic colorectal surgery is a safe and effective technique that exploits the advantages of the Da Vinci robot during the whole intervention, without the need to make use of hybrid operations. Outcome and pathology findings are comparable with those observed in open and laparoscopy procedures.