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Robotic-Assisted Surgery Improves the Quality of Total Mesorectal Excision for Rectal Cancer Compared to Laparoscopy: Results of a Case–Controlled Analysis

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Abstract

Background

The use of a robotic surgical system is claimed to allow precise traction and counter-traction, especially in a narrow pelvis. Whether this translates to improvement of the quality of the resected specimen is not yet clear. The aim of the study was to compare the quality of the TME and the short-term oncological outcome between robotic and laparoscopic rectal cancer resections.

Methods

20 consecutive robotic TME performed in a single institution for rectal cancer (Rob group) were matched 1:2 to 40 laparoscopic resections (Lap group) for gender, body mass index (BMI), and distance from anal verge on rigid proctoscopy. The quality of TME was assessed by 2 blinded and independent pathologists and reported according to international standardized guidelines.

Results

Both samples were well matched for gender, BMI (median 25.9 vs. 24.2 kg/m2, p = 0.24), and level of the tumor (4.1 vs. 4.8 cm, p = 0.20). The quality of the TME was better in the Robotic group (complete TME: 95 vs. 55 %; p = 0.0003, nearly complete TME 5 vs. 37 %; p = 0.04, incomplete TME 0 vs. 8 %, p = 0.09). A trend for lower positive circumferential margin was observed in the Robotic group (10 vs. 25 %, p = 0.1).

Conclusions

These results suggest that robotic-assisted surgery improves the quality of TME for rectal cancer. Whether this translates to better oncological outcome needs to be further investigated.

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Authors and Affiliations

  1. Department of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Pierre Allemann, Céline Duvoisin, Luca Di Mare, Martin Hübner, Nicolas Demartines & Dieter Hahnloser

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  1. Pierre Allemann
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  2. Céline Duvoisin
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  3. Luca Di Mare
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  4. Martin Hübner
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  5. Nicolas Demartines
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  6. Dieter Hahnloser
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Correspondence to Dieter Hahnloser.

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All authors declare to have no biomedical financial interests or potential conflicts of interest of any nature. The study was fully supported by our institution, without any external funding.

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Allemann, P., Duvoisin, C., Di Mare, L. et al. Robotic-Assisted Surgery Improves the Quality of Total Mesorectal Excision for Rectal Cancer Compared to Laparoscopy: Results of a Case–Controlled Analysis. World J Surg 40, 1010–1016 (2016). https://doi.org/10.1007/s00268-015-3303-2

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  • DOI: https://doi.org/10.1007/s00268-015-3303-2

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