Totally robotic rectal resection: an experience of the first 100 consecutive cases
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Robotic surgery provides an alternative option for a minimal access approach. It provides a stable platform with high definition three-dimensional views and improved access, which enhances the capabilities for precise dissection in a narrow surgical field. These distinctive features have made it an attractive option for colorectal surgeons.
The aim of this study was to present a standardised technique for single-docking robotic rectal resection and to analyse clinical outcomes of the first 100 robotic rectal procedures performed in a single centre between May 2013 and April 2015.
Prospectively collected data related to 100 consecutive patients who underwent single-docking robotic rectal surgery was analysed for surgical and oncological outcomes.
Sixty-six patients were male, the median age was 67 years (range-24–92). Eighteen patients had neo-adjuvant chemoradiotherapy whilst 23 patients had BMI >30. Procedures performed included anterior resection (n = 74), abdominoperineal resection (n = 10), completion proctectomy (n = 9), restorative proctectomy with ileal pouch–anal anastomosis (IPAA) (n = 5) and Hartmann’s procedure (n = 2). The median operating time was 240 min (range-135–456), and median blood loss was 10 ml (range 0–200). There was no conversion or intra-operative complication. Median length of stay was 7 days (range, 3–48) and readmission rate was 12 %. Thirty-day mortality was zero. Postoperatively, two patients had an anastomotic leak whilst two had small bowel obstruction. The median lymph node harvest was 18 (range, 6–43).
The single-docking robotic technique should be considered as an alternative option for rectal surgery. This approach is safe and feasible and in our study it has demonstrated favourable clinical outcomes.
KeywordsColorectal Minimally invasive surgery Robotic surgery Pelvic surgery
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