Abstract
Purpose
Intraoperative pelvic neuromapping with electrophysiological evaluation of autonomic nerve preservation during robotic total mesorectal excision (TME) for rectal cancer is conventionally performed by the bedside assistant with a hand-guided probe. Our goal was to return autonomy over the neuromonitoring process to the colorectal surgeon operating the robotic console.
Methods
A recently described prototype microfork electrostimulation probe was evaluated intraoperatively during abdominal robotic-assisted transanal TME (taTME) surgery for low rectal cancer in three consecutive male patients.
Results
An intraoperative video demonstrates the good control and maneuverability of the prototype probe with electrophysiological confirmation of bilateral pelvic autonomic nerve preservation.
Conclusions
This study presents the first in situ application of a new microfork probe for fully robot-guided neuromapping in three patients undergoing TME surgery for low rectal cancer.
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References
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Acknowledgements
We would like to thank Dipl.-Ing. K. Somerlik-Fuchs (inomed Medizintechnik GmbH, Emmendingen, Germany) for commitment and technical support.
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The authors declare that they have no conflict of interest.
Ethical approval
This research was performed in accordance with the 1964 Helsinki declaration and its later amendments. Patient information was collected prospectively and entered into an international registry database for taTME (LOREC Low Rectal Cancer Development Program, www.lorec.nhs.uk) with approval by the local ethics board (Rhineland Palatinate, Germany).
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Informed consent was obtained from all patients.
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Schiemer, J.F., Zimniak, L., Grimminger, P. et al. Robot-guided neuromapping during nerve-sparing taTME for low rectal cancer. Int J Colorectal Dis 33, 1803–1805 (2018). https://doi.org/10.1007/s00384-018-3126-3
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DOI: https://doi.org/10.1007/s00384-018-3126-3