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Transanal Robotic Surgery and Future Directions

  • Kevin M. Izquierdo
  • Thushy Siva
  • Jean Salem
  • Brigitte Anderson
  • John Marks
Chapter

Abstract

Transanal surgery draws its roots from transanal endoscopic microsurgery (TEM), invented by Dr. Gerhard Buess in 1983, and the transanal abdominal transanal proctosigmoidectomy (TATA), as described by Dr. Gerald Marks in 1984. Early experience in TEM focused on excision of benign rectal lesions but was later successfully expanded to the treatment of partial thickness rectal cancer. TATA allowed for the radical excision of distal rectal cancer and addressed the difficulties of operating in the narrow pelvis, obtaining a known distal margin in the radiated rectum and allowing for sphincter preservation with the avoidance of a permanent colostomy. Recent evolution in technology has built upon these techniques and allowed total mesorectal excision to be performed entirely transanally. The challenges of transanal surgery have limited its adoption; however, recent advances in robotic surgery, which include novel platforms such as the Flex® Robotic System, STRAS robot, and da Vinci SP Surgical System, promise to broaden the accessibility of this technique to more surgeons and patients.

Keywords

Transanal Robotic Rectal cancer taTME TAMIS TEM RTS 

Abbreviations

MIS

Minimally invasive surgery

NOTES

Natural orifice transluminal endoscopic surgery

RATS-TME

Robotic transanal total mesorectal excision; robotic taTME

RTAS

Robotic transanal surgery

SILS

Single incision laparoscopic surgery

TAMIS

Transanal minimally invasive surgery

TATA

Transanal transabdominal proctosigmoidectomy

taTME

Transanal total mesorectal excision

TEM

Transanal endoscopic microsurgery

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Kevin M. Izquierdo
    • 1
  • Thushy Siva
    • 2
  • Jean Salem
    • 1
  • Brigitte Anderson
    • 3
  • John Marks
    • 3
  1. 1.Lankenau Medical Center, Division of Colorectal SurgeryWynnewoodUSA
  2. 2.Easton Hospital, Department of SurgeryEastonUSA
  3. 3.Colon and Rectal Surgery, Lankenau Medical Center, Marks Colorectal Surgical AssociatesWynnewoodUSA

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