Skip to main content
Top
Published in: Techniques in Coloproctology 6/2021

01-06-2021 | Rectal Cancer | Original Article

Robotic-assisted transanal total mesorectal excision for rectal cancer: technique and results from a single institution

Authors: J. Ye, H. Shen, F. Li, Y. Tian, Y. Gao, S. Zhao, B. Liu, W. Tong

Published in: Techniques in Coloproctology | Issue 6/2021

Login to get access

Abstract

Background

Total mesorectal excision (TME) has greatly reduced the local recurrence rate of rectal cancer after colorectal surgery. Transanal TME (TaTME) is potentially a suitable option for patients with mid and low rectal cancer. Robotic systems overcome the limitations of laparoscopic surgery. The aim of this study was to investigate the safety and feasibility of robotic-assisted transanal total mesorectal excision (RTaTME) in patients with rectal cancer.

Methods

The clinical data of patients who underwent RTaTME for rectal cancer between May 2017 and January 2020 were reviewed. The perioperative data and short-term outcomes of all the patients were retrospectively analysed. Last follow-up was in May 2020.

Results

A total of 13 patients had RTaTME during the 36-month study period. The median docking time was 18 (IQR 16–20) minutes, median transanal phase time was 95 (IQR 74–100) minutes, median total operation time was 240 (IQR 195–270) minutes, median estimated blood loss was 60 (IQR 50–100) ml, the median number of lymph nodes retrieved was 15 (IQR 13–16) and median length of postoperative hospital stay was 7 (IQR 6–10) days. There was no mortality. Three (23%) patients suffered a postoperative complication including one anastomotic leak and one prolonged ileus, none of them required any intervention. Patients were followed up for a median of 15 (IQR 11–18) months, and no local tumour recurrences, metastasis or deaths were reported.

Conclusions

Our preliminary results suggest that RTaTME for rectal cancer is feasible. This innovative approach may offer patients potential benefits—further studies are needed
Literature
3.
go back to reference Kang L, Wang J (2016) Current situation and outlook of transanal total mesorectum excision in rectal cancer. Zhonghua Wei Chang Wai Ke Za Zhi Yea 19:850–853 [PMID: 27545460] Kang L, Wang J (2016) Current situation and outlook of transanal total mesorectum excision in rectal cancer. Zhonghua Wei Chang Wai Ke Za Zhi Yea 19:850–853 [PMID: 27545460]
5.
go back to reference Kuo LJ, Ngu JC, Tong YS, Chen CC (2017) 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. Int J Colorectal Dis Yea 32:249–254. https://doi.org/10.1007/s00384-016-2686-3(PMID: 27744632)CrossRef Kuo LJ, Ngu JC, Tong YS, Chen CC (2017) 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. Int J Colorectal Dis Yea 32:249–254. https://​doi.​org/​10.​1007/​s00384-016-2686-3(PMID: 27744632)CrossRef
8.
go back to reference Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, Quirke P, West N, Rautio T, Thomassen N, Tilney H, Gudgeon M, Bianchi PP, Edlin R, Hulme C, Brown J (2017) Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA Yea 318:1569–1580. https://doi.org/10.1001/jama.2017.7219(PMID: 29067426)CrossRef Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, Quirke P, West N, Rautio T, Thomassen N, Tilney H, Gudgeon M, Bianchi PP, Edlin R, Hulme C, Brown J (2017) Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA Yea 318:1569–1580. https://​doi.​org/​10.​1001/​jama.​2017.​7219(PMID: 29067426)CrossRef
13.
go back to reference Ye J, Huang B, Tong W, Fu T, Li C, Wang X, Zhao S, Wang L, Shi L, Liu B (2015) Clinical analysis of 11 cases undergoing transanal minimal invasive or combined laparoscopy total mesorectal excision for rectal cancer. Zhonghua Wei Chang Wai Ke Za Zhi Yea 18:821–825 (PMID: 26303695) Ye J, Huang B, Tong W, Fu T, Li C, Wang X, Zhao S, Wang L, Shi L, Liu B (2015) Clinical analysis of 11 cases undergoing transanal minimal invasive or combined laparoscopy total mesorectal excision for rectal cancer. Zhonghua Wei Chang Wai Ke Za Zhi Yea 18:821–825 (PMID: 26303695)
20.
go back to reference Atallah S, Nassif G, Polavarapu H, deBeche-Adams T, Ouyang J, Albert M, Larach S (2013) Robotic-assisted transanal surgery for total mesorectal excision (RATS-TME): a description of a novel surgical approach with video demonstration. Tech Coloproctol Yea 17:441–447. https://doi.org/10.1007/s10151-013-1039-2(PMID: 23801366)CrossRef Atallah S, Nassif G, Polavarapu H, deBeche-Adams T, Ouyang J, Albert M, Larach S (2013) Robotic-assisted transanal surgery for total mesorectal excision (RATS-TME): a description of a novel surgical approach with video demonstration. Tech Coloproctol Yea 17:441–447. https://​doi.​org/​10.​1007/​s10151-013-1039-2(PMID: 23801366)CrossRef
21.
go back to reference Atallah S, Martin-Perez B, Parra-Davila E, deBeche-Adams T, Nassif G, Albert M, Larach S (2015) Robotic transanal surgery for local excision of rectal neoplasia, transanal total mesorectal excision, and repair of complex fistulae: clinical experience with the first 18 cases at a single institution. Tech Coloproctol Yea 19:401–410. https://doi.org/10.1007/s10151-015-1283-8(PMID: 25708682)CrossRef Atallah S, Martin-Perez B, Parra-Davila E, deBeche-Adams T, Nassif G, Albert M, Larach S (2015) Robotic transanal surgery for local excision of rectal neoplasia, transanal total mesorectal excision, and repair of complex fistulae: clinical experience with the first 18 cases at a single institution. Tech Coloproctol Yea 19:401–410. https://​doi.​org/​10.​1007/​s10151-015-1283-8(PMID: 25708682)CrossRef
23.
go back to reference Ye J, Tian Y, Wang L, Ye Y, Zhang Y, Li F, Liu B, Tong W (2017) Robotic-assisted transanal total mesorectal excision for lower rectal cancer. Zhonghua Wei Chang Wai Ke Za Zhi Yea 20:900–903 [PMID: 28836251] Ye J, Tian Y, Wang L, Ye Y, Zhang Y, Li F, Liu B, Tong W (2017) Robotic-assisted transanal total mesorectal excision for lower rectal cancer. Zhonghua Wei Chang Wai Ke Za Zhi Yea 20:900–903 [PMID: 28836251]
Metadata
Title
Robotic-assisted transanal total mesorectal excision for rectal cancer: technique and results from a single institution
Authors
J. Ye
H. Shen
F. Li
Y. Tian
Y. Gao
S. Zhao
B. Liu
W. Tong
Publication date
01-06-2021
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 6/2021
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-020-02337-z

Other articles of this Issue 6/2021

Techniques in Coloproctology 6/2021 Go to the issue