International Journal of Colorectal Disease

, Volume 32, Issue 2, pp 249–254 | Cite as

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

  • Li-Jen Kuo
  • James Chi-Yong Ngu
  • Yiu-Shun Tong
  • Chia-Che Chen
Original Article



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.


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.


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.


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.


Rectal cancer Robotic surgery Single-site Transanal total mesorectal excision 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Li-Jen Kuo
    • 1
    • 2
    • 3
  • James Chi-Yong Ngu
    • 4
  • Yiu-Shun Tong
    • 5
  • Chia-Che Chen
    • 5
  1. 1.Division of Colorectal Surgery, Department of SurgeryTaipei Medical University HospitalTaipeiTaiwan
  2. 2.Graduate Institute of Clinical Medicine, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  3. 3.Department of Surgery, School of Medicine, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  4. 4.Department of SurgeryChangi General HospitalSingaporeSingapore
  5. 5.Division of Acute Care Surgery and Traumatology, Department of SurgeryTaipei Medical University HospitalTaipeiTaiwan

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