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Nerve Preservation in Robotic Rectal Surgery

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Abstract

In recent decades colorectal carcinoma has become the second most common cancer in Europe and the United States both in males (after lung cancer) and in females (after breast cancer) [1]. The principal goal of rectal cancer treatment is cure, and in recent years we have seen an increase in survival from rectal cancer, due largely to advances in surgical techniques such as total mesorectal excision (TME), earlier diagnosis, and the improvement of efficacy of adjuvant radio- and chemotherapy [2, 3].

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References

  1. Weir HK, Thun MJ, Hankey BF, et al. Annual report to the nation on the status of cancer, 1975-2000, featuring the uses of surveillance data for cancer prevention and control. J Natl Cancer Inst. 2003;95:1276–99.

    Article  PubMed  Google Scholar 

  2. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg. 1982;69:613–6.

    Article  CAS  PubMed  Google Scholar 

  3. Kapiteijn E, van de Velde CJ. The role of total mesorectal excision in the management of rectal cancer. Surg Clin North Am. 2002;82:995–1007.

    Article  CAS  PubMed  Google Scholar 

  4. Santangelo ML, Romano G, Sassaroli C. Sexual function after resection for rectal cancer. Am J Surg. 1987;154:502–4.

    Article  CAS  PubMed  Google Scholar 

  5. Kinn C, Ohman U. Bladder and sexual function after surgery for rectal cancer. Dis Colon Rectum. 1986;29:43–8.

    Article  CAS  PubMed  Google Scholar 

  6. Chang PL, Fan HA. Urodynamic studies before and/or after abdominoperineal resection of the rectum for carcinoma. J Urol. 1983;130:948–51.

    CAS  PubMed  Google Scholar 

  7. Havenga K, Enker WE, McDermott K, et al. Male and female sexual function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectum. J Am Coll Surg. 1996;182:495–502.

    CAS  PubMed  Google Scholar 

  8. Sterk P, Shekarriz B, Günter S, Nolde J, Keller R, Bruch HP, Shekarriz H. Voiding and sexual dysfunction after deep rectal resection and total mesorectal excision: prospective study on 52 patients. Int J Colorectal Dis. 2005;20:423–7.

    Article  PubMed  Google Scholar 

  9. Maurer CA, Z’Graggen K, Renzulli P, Schilling MK, Netzer P, Buchler MW. Total mesorectal excision preserves male genital function compared with conventional rectal cancer surgery. Br J Surg. 2001;88:1501–5.

    Article  CAS  PubMed  Google Scholar 

  10. Schmidt C, Daun A, Malchow B, Küchler T. Sexual impairment and its effects on quality of life in patients with rectal cancer. Dtsch Arztebl Int. 2010;107:123–30.

    PubMed  PubMed Central  Google Scholar 

  11. Raina R, Pahlajani G, Khan S, Gupta S, Agarwal A, Zippe CD. Female sexual dysfunction: classification, pathophysiology, and management. Fertil Steril. 2007;88:1273–84.

    Article  PubMed  Google Scholar 

  12. Kandeel FR, Koussa VK, Swerdloff RS. Male sexual function and its disorders: physiology, pathophysiology, clinical investigation, and treatment. Endocr Rev. 2001;22:342–88.

    Article  CAS  PubMed  Google Scholar 

  13. Breukink SO, van der Zaag-Loonen HJ, Bouma EM, Pierie JP, Hoff C, Wiggers T, Meijerink WJ. Prospective evaluation of quality of life and sexual functioning after laparoscopic total mesorectal excision. Dis Colon Rectum. 2007;50:147–55.

    Article  CAS  PubMed  Google Scholar 

  14. Ho VP, Lee Y, Stein SL, Temple LK. Sexual function after treatment for rectal cancer: a review. Dis Colon Rectum. 2011;54:113–25.

    Article  PubMed  Google Scholar 

  15. Lindsey I, Guy RJ, Warren BF, Mortensen NJ. Anatomy of Denonvilliers’ fascia and pelvic nerves, impotence, and implications for the colorectal surgeon. Br J Surg. 2000;87:1288–99.

    Article  CAS  PubMed  Google Scholar 

  16. Lange MM, Marijnen CA, Maas CP, Putter H, Rutten HJ, Stiggelbout AM, Meershoek-Klein Kranenbarg E, van de Velde CJ, Cooperative Clinical Investigators of the Dutch. Risk factors for sexual dysfunction after rectal cancer treatment. Eur J Cancer. 2009;45:1578–88.

    Article  CAS  PubMed  Google Scholar 

  17. Kasparek MS, Hassan I, Cima RR, Larson DR, Gullerud RE, Wolff BG. Long-term Quality of Life and Sexual and Urinary Function After Abdominoperineal Resection for Distal Rectal Cancer. Dis Colon Rectum. 2012;55:147–54.

    Article  PubMed  Google Scholar 

  18. Heriot AG, Tekkis PP, Fazio VW, et al. Adjuvant radiotherapy is associated with increased sexual dysfunction in male patients undergoing resection for rectal cancer. Ann Surg. 2005;242:502–5011.

    PubMed  PubMed Central  Google Scholar 

  19. Moriya Y. Functional preservation in rectal cancer surgery. Int J Clin Oncol. 2006;11:339–43.

    Article  PubMed  Google Scholar 

  20. Maas CP, Moriya Y, Steup WH, et al. A prospective study on radical and nerve preserving surgery for rectal cancer in the Netherlands. Eur J Surg Oncol. 2000;26:751–7.

    Article  CAS  PubMed  Google Scholar 

  21. Banerjee AK. Sexual dysfunction after surgery for rectal cancer. Lancet. 1999;354:772–3.

    Google Scholar 

  22. Hendren SK, O’Connor BI, Liu M, Asano T, Cohen Z, Swallow CJ, Macrae HM, Gryfe R, McLeod RS. Prevalence of male and female sexual dysfunction is high following surgery for rectal cancer. Ann Surg. 2005;242:212–23.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Berman JR, Berman LA, Kanaly KA. Female sexual dysfunction: new perspectives on anatomy, physiology, evaluation and treatment. EAU Update Series. 2003;1:166–77.

    Article  Google Scholar 

  24. Daniel IR, Woodward S, Taylor FGM, et al. Female urogenital dysfunction following total mesorectal excision for rectal cancer. World J Surg Oncol. 2006;4:6–9.

    Article  Google Scholar 

  25. Baek JH, McKenzie S, Garcia-Aguilar J, et al. Oncologic outcomes of robotic-assisted total mesorectal excision for the treatment of rectal cancer. Ann Surg. 2010;251(5):882–6.

    Article  PubMed  Google Scholar 

  26. Kim NK, Kang J. Optimal total mesorectal excision for rectal cancer: the role of robotic surgery from an expert’s view. J Korean Soc Coloproctol. 2010;26(6):377–87.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Stamopoulos P, Theodoropoulos GE, Papailiou J, et al. Prospective evaluation of sexual function after open and laparoscopic surgery for rectal cancer. Surg Endosc. 2009;23(12):2665–74.

    Article  PubMed  Google Scholar 

  28. Jayne DG, Brown JM, Thorpe H, Walker J, Quirke P, Guillou PJ. Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique. Br J Surg. 2005;92:1124–32.

    Article  CAS  PubMed  Google Scholar 

  29. Quah HM, Jayne DG, Eu KW, Seow-Choen F. Bladder and sexual dysfunction following laparoscopically assisted and conventional open mesorectal resection for cancer. Br J Surg. 2002;89:1551–6.

    Article  CAS  PubMed  Google Scholar 

  30. Nitori N, Hasegawa H, Ishii Y, Endo T, Kitajima M, Kitagawa Y. Sexual function in men with rectal and rectosigmoid cancer after laparoscopic and open surgery. Hepatogastroenterology. 2008;55:1304–7.

    CAS  PubMed  Google Scholar 

  31. Morino M, Parini U, Allaix ME, Monasterolo G, Brachet Contul R, Garrone C. Male sexual and urinary function after laparoscopic total mesorectal excision. Surg Endosc. 2009;23:1233–40.

    Article  PubMed  Google Scholar 

  32. Bege T, Lelong B, Esterni B, Turrini O, Guiramand J, Francon D, Mokart D, Houvenaeghel G, Giovannini M, Delpero JR. The learning curve for the laparoscopic approach to conservative mesorectal excision for rectal cancer: lessons drawn from a single institution’s experience. Ann Surg. 2010;251:249–53.

    Article  PubMed  Google Scholar 

  33. Jamali FR, Soweid AM, Dimassi H, Bailey C, Leroy J, Marescaux J. Evaluating the degree of difficulty of laparoscopic colorectal surgery. Arch Surg. 2008;143:762–7.

    Article  PubMed  Google Scholar 

  34. Marusch F, Gastinger I, Schneider C, Scheidbach H, Konradt J, Bruch HP, Köhler L, Bärlehner E, Köckerling F, Laparoscopic Colorectal Surgery Study Group (LCSSG). Experience as a factor influencing the indications for laparoscopic colorectal surgery and the results. Surg Endosc. 2001;15:116–20.

    Article  CAS  PubMed  Google Scholar 

  35. Poon JT, Law WL. Laparoscopic resection for rectal cancer: a review. Ann Surg Oncol. 2009;16:3038–47.

    Article  PubMed  Google Scholar 

  36. Pigazzi A, Luca F, Patriti A, et al. Multicentric study on robotic tumor-specific mesorectal excision for the treatment of rectal cancer. Ann Surg Oncol. 2010;17(6):1614–20.

    Article  PubMed  Google Scholar 

  37. deSouza AL, Prasad LM, Marecik SJ, et al. Total mesorectal excision for rectal cancer: the potential advantage of robotic assistance. Dis Colon Rectum. 2010;53(12):1611–7.

    Article  PubMed  Google Scholar 

  38. Antoniou SA, Antoniou GA, Koch OO, Pointner R, Granderath FA. Robot-assisted laparoscopic surgery of the colon and rectum. Surg Endosc. 2012;26(1):1–11.

    Article  PubMed  Google Scholar 

  39. Luca F, Valvo M, Ghezzi TL, Zuccaro M, Cenciarelli S, Trovato C, Sonzogni A, Biffi R. Impact of robotic surgery on sexual and urinary function after fully robotic nerve- sparing total mesorectal excision for rectal cancer. Ann Surg. 2013;257(4):672–8.

    Article  PubMed  Google Scholar 

  40. Graziottin A, Giraldi A. Anatomy and physiology of women’s sexual function. In: Porst H, Buvat J, editors. ISSM (International Society of Sexual Medicine) Standard committee book, standard practice in sexual medicine. Oxford: Blackwell; 2006. p. 289–304.

    Google Scholar 

  41. Lange MM, van de Velde CJ. Urinary and sexual dysfunction after rectal cancer treatment. Nat Rev Urol. 2011;8(1):51–7.

    Article  PubMed  Google Scholar 

  42. Moszkowicz D, Alsaid B, Bessede T, Penna C, Nordlinger B, Benoît G, Peschaud F. Where does pelvic nerve injury occur during rectal surgery for cancer? Colorectal Dis. 2011;13:1326–34.

    Article  CAS  PubMed  Google Scholar 

  43. Quirke P, Dixon MF. The prediction of local recurrence in rectal adenocarcinoma by histopathological examination. Int J Colorectal Dis. 1988;3:127–31.

    Article  CAS  PubMed  Google Scholar 

  44. Walsh PC, Donker PJ. Impotence following radical prostatectomy: insight into etiology and prevention. 1982. J Urol. 2002;167(2 Pt 2):1005–10.

    Article  PubMed  Google Scholar 

  45. Cangiano TG, Litwin MS, Naitoh J, Dorey F, de Kernion JB. Intraoperative frozen section monitoring of nerve sparing radical retropubic prostatectomy. J Urol. 1999;162(3 Pt 1):655–8.

    Article  CAS  PubMed  Google Scholar 

  46. Ameda K, Kakizaki H, Koyanagi T, Hirakawa K, Kusumi T, Hosokawa M. The long-term voiding function and sexual function after pelvic nerve-sparing radical surgery for rectal cancer. Int J Urol. 2005;12:256–63.

    Article  PubMed  Google Scholar 

  47. Kinugasa Y, Murakami G, Uchimoto K, Takenaka A, Yajima T, Sugihara K. Operating behind Denonvilliers’ fascia for reliable preservation of urogenital autonomic nerves in total mesorectal excision: a histologic study using cadaveric specimens, including a surgical experiment using fresh cadaveric models. Dis Colon Rectum. 2006;49:1024–32.

    Article  PubMed  Google Scholar 

  48. Tekkis PP, Cornish JA, Remzi FH, Tilney HS, Strong SA, Church JM, Lavery IC, Fazio VW. Measuring sexual and urinary outcomes in women after rectal cancer excision. Dis Colon Rectum. 2009;52(1):46–54.

    Article  CAS  PubMed  Google Scholar 

  49. Kim NK, Aahn TW, Park JK, Lee KY, Lee WH, Sohn SK, Min JS. Assessment of sexual and voiding function after total mesorectal excision with pelvic autonomic nerve preservation in males with rectal cancer. Dis Colon Rectum. 2002;45(9):1178–85.

    Article  PubMed  Google Scholar 

  50. Hojo K, Vernava 3rd AM, Sugihara K, Katumata K. Preservation of urine voiding and sexual function after rectal cancer surgery. Dis Colon Rectum. 1991;34(7):532–9.

    Article  CAS  PubMed  Google Scholar 

  51. Schmidt CE, Bestmann B, Küchler T, Longo WE, Kremer B. Ten-year historic cohort of quality of life and sexuality in patients with rectal cancer. Dis Colon Rectum. 2005;48(3):483–92.

    Article  PubMed  Google Scholar 

  52. Varpe P, Huhtinen H, Rantala A, Salminen P, Rautava P, Hurme S, Grönroos J. Quality of life after surgery for rectal cancer with special reference to pelvic floor dysfunction. Colorectal Dis. 2011;13:399–405.

    Article  CAS  PubMed  Google Scholar 

  53. Pocard M, Zinzindohoue F, Haab F, Caplin S, Parc R, Tiret E. A prospective study of sexual and urinary function before and after total mesorectal excision with autonomic nerve preservation for rectal cancer. Surgery. 2002;131:368–72.

    Article  PubMed  Google Scholar 

  54. Berman JR. Physiology of female sexual function and dysfunction. Int J Impot Res. 2005;17:S44–51.

    Article  PubMed  Google Scholar 

  55. Hellan M, Stein H, Pigazzi A. Totally robotic low anterior resection with total mesorectal excision and splenic flexure mobilization. Surg Endosc. 2009;23:447–51.

    Article  PubMed  Google Scholar 

  56. Luca F, Cenciarelli S, Valvo M, Pozzi S, Faso FL, Ravizza D, Zampino G, Sonzogni A, Biffi R. Full robotic left colon and rectal cancer resection: technique and early outcome. Ann Surg Oncol. 2009;16:1274–8.

    Article  PubMed  Google Scholar 

  57. Park YA, Kim JM, Kim SA, Min BS, Kim NK, Sohn SK, Lee KY. Totally robotic surgery for rectal cancer: from splenic flexure to pelvic floor in one setup. Surg Endosc. 2010;24:715–20.

    Article  PubMed  Google Scholar 

  58. Choi DJ, Kim SH, Lee PJ, Kim J, Woo SU. Single-stage totally robotic dissection for rectal cancer surgery: technique and short-term outcome in 50 consecutive patients. Dis Colon Rectum. 2009;52:1824–30.

    Article  PubMed  Google Scholar 

  59. Parra-Davila E, Diaz-Hernandez JJ. Totally robotic left colectomy. J Robotic Surg. 2011;5:57–64.

    Article  Google Scholar 

  60. Baik SH, Lee WJ, Rha KH, Kim NK, Sohn SK, Chi HS, Cho CH, Lee SK, Cheon JH, Ahn JB, Kim WH. Robotic total mesorectal excision for rectal cancer using four robotic arms. Surg Endosc. 2008;22:792–7.

    Article  PubMed  Google Scholar 

  61. Blumetti J, de Souza AL, Prasad LM. Hybrid laparoscopic-robotic low anterior resection. Semin Colon Rectal Surg. 2009;20:181–4.

    Article  Google Scholar 

  62. Tewary A, Srivastava A, Sooriakumaran P, et al. Technique of traction-free nerve sparing robotic prostatectomy: delicate tissue handling by real-time penile oxygen monitoring. Int J Impot Res. 2012;24(1):11–9.

    Article  Google Scholar 

  63. Wall E, Massie J, Kwan M, et al. Experimental stretch neuropathy, changes in nerve conduction under tension. J Bone Joint Surg Br. 1992;74:126–9.

    CAS  PubMed  Google Scholar 

  64. Kowalczyk KJ, Huang AC, Hevelone ND, Lipsitz SR, Yu HY, Ulmer WD, Kaplan JR, Patel S, Nguyen PL, Hu JC. Stepwise approach for nerve sparing without countertraction during robot-assisted radical prostatectomy: technique and outcomes. Eur Urol. 2011;60(3):536–47.

    Article  PubMed  Google Scholar 

  65. Junginger T, Kneist W, Heintz A. Influence of identification and preservation of pelvic autonomic nerves in rectal cancer surgery on bladder dysfunction after total mesorectal excision. Dis Colon Rectum. 2003;46:621–8.

    Article  CAS  PubMed  Google Scholar 

  66. Celentano V, Fabbrocile G, Luglio G, Antonelli G, Tarquini R, Bucci L. Prospective study of sexual dysfunction in men with rectal cancer: feasibility and results of nerve sparing surgery. Int J Colorectal Dis. 2010;25:1441–5.

    Article  PubMed  Google Scholar 

  67. da Silva GM, Zmora O, Borjesson L, et al. The efficacy of a nerve stimulator (CaverMap) to enhance autonomic nerve identification and confirm nerve preservation during total mesorectal excision. Dis Colon Rectum. 2004;47:2032–8.

    Article  PubMed  Google Scholar 

  68. Saito N, Koda K, Nobuhiro K, Takiguchi K, Oda K, Soda H, Nunomura M, Sarashina H, Nakajima N. Nerve-sparing surgery for advanced rectal cancer patients: special reference to Dukes C patients. World J Surg. 1999;23:1062–8.

    Article  CAS  PubMed  Google Scholar 

  69. Havenga K, DeRuiter MC, Enker WE, Welvaart K. Anatomical basis of autonomic nerve-preserving total mesorectal excision for rectal cancer. Br J Surg. 1996;83:384–8.

    Article  CAS  PubMed  Google Scholar 

  70. Biffi R, Luca F, Pozzi S, Cenciarelli S, Valvo M, Sonzogni A, Radice D, Ghezzi TL. Operative blood loss and use of blood products after full robotic and conventional low anterior resection with total mesorectal excision for treatment of rectal cancer. J Robot Surg. 2011;5(2):101–7.

    Article  PubMed  Google Scholar 

  71. Eveno C, Lamblin A, Mariette C, Pocard M. Sexual and urinary dysfunction after proctectomy for rectal cancer. J Visc Surg. 2010;147:e21–30.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Loma Linda University Health, Loma Linda, (CA), USA

    Fabrizio Luca M.D., F.A.S.C.R.S.

  2. Division of Digestive Surgery, European Institute of Oncology, Milan, Italy

    Manuela Valvo M.D.

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  1. Fabrizio Luca M.D., F.A.S.C.R.S.
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  2. Manuela Valvo M.D.
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Correspondence to Fabrizio Luca M.D., F.A.S.C.R.S. .

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Editors and Affiliations

  1. Department of Surger Division of Colon and Rectal Surgery, George Washington University, Washington, DC, District of Columbia, USA

    Vincent Obias

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Luca, F., Valvo, M. (2017). Nerve Preservation in Robotic Rectal Surgery. In: Obias, V. (eds) Robotic Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-43256-4_14

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  • DOI: https://doi.org/10.1007/978-3-319-43256-4_14

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