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Robotic-assisted transanal total mesorectal excision for rectal cancer: technique and results from a single institution

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Abstract

Background

Total mesorectal excision (TME) has greatly reduced the local recurrence rate of rectal cancer after colorectal surgery. Transanal TME (TaTME) is potentially a suitable option for patients with mid and low rectal cancer. Robotic systems overcome the limitations of laparoscopic surgery. The aim of this study was to investigate the safety and feasibility of robotic-assisted transanal total mesorectal excision (RTaTME) in patients with rectal cancer.

Methods

The clinical data of patients who underwent RTaTME for rectal cancer between May 2017 and January 2020 were reviewed. The perioperative data and short-term outcomes of all the patients were retrospectively analysed. Last follow-up was in May 2020.

Results

A total of 13 patients had RTaTME during the 36-month study period. The median docking time was 18 (IQR 16–20) minutes, median transanal phase time was 95 (IQR 74–100) minutes, median total operation time was 240 (IQR 195–270) minutes, median estimated blood loss was 60 (IQR 50–100) ml, the median number of lymph nodes retrieved was 15 (IQR 13–16) and median length of postoperative hospital stay was 7 (IQR 6–10) days. There was no mortality. Three (23%) patients suffered a postoperative complication including one anastomotic leak and one prolonged ileus, none of them required any intervention. Patients were followed up for a median of 15 (IQR 11–18) months, and no local tumour recurrences, metastasis or deaths were reported.

Conclusions

Our preliminary results suggest that RTaTME for rectal cancer is feasible. This innovative approach may offer patients potential benefits—further studies are needed

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Funding

Supported by the National Natural Science Foundation of China (81570483, and 81770541), and a clinical innovation project of Army Medical University (2014YLC04; 2019CXLCB004).

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Author notes

  1. Jingwang Ye and Haode Shen contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China

    J. Ye, H. Shen, F. Li, Y. Tian, Y. Gao, S. Zhao, B. Liu & W. Tong

  2. Department of General Surgery, The People’s Hospital of Shapingba District, Chongqing, 404000, China

    J. Ye

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  1. J. Ye
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Correspondence to W. Tong.

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This retrospective review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Ethics Committee of Daping Hospital approved this study.

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Ye, J., Shen, H., Li, F. et al. Robotic-assisted transanal total mesorectal excision for rectal cancer: technique and results from a single institution. Tech Coloproctol 25, 693–700 (2021). https://doi.org/10.1007/s10151-020-02337-z

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  • DOI: https://doi.org/10.1007/s10151-020-02337-z

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