Robot-assisted TME with coloanal anastomosis

Han Deok Kwak, Seon Hahn Kim

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Since total mesorectal excision (TME) was introduced in 1982 [1], it has become a standard procedure for the treatment of rectal cancer. For low rectal cancer, coloanal anastomosis (CAA) [2] after ultralow anterior resection (uLAR) or intersphincteric resection (ISR) [3] along with TME has provided positive functional, psychological, and oncological outcomes. These outcomes of surgical techniques are also owed to the development of anatomical knowledge and perioperative treatment [4]. Robotic systems offer surgeons several benefits, though there have been controversial issues. Recent reports have indicated that robotic surgery is feasible and safe compared to laparoscopic surgery [5-7]. Robotic surgery enables easier performance of intersphincteric dissection for very low-lying rectal cancer, especially when accompanied with unfavorable factors such as high body mass index or preoperative radiation, leading to satisfactory surgical, functional, and oncological outcomes compared to conventional laparoscopy [8]. It also provides earlier recovery of sexual and bladder functions [6], lower conversion rate, and shorter hospital stay [9]. Although multicenter, randomized prospective trials are needed, robot-assisted TME with CAA with or without ISR has potential benefits for low rectal cancer. In this chapter, the authors introduce the robotic approach of TME with CAA, which is performed with or without ISR. The procedures include patient positioning, trocar placement, docking, abdominal/pelvic phases, and useful technical tips as well as CAA and ISR.

Original languageEnglish
Title of host publicationSurgical Techniques in Rectal Cancer
Subtitle of host publicationTransanal, Laparoscopic and Robotic Approach
PublisherSpringer Japan
Pages289-310
Number of pages22
ISBN (Electronic)9784431555797
ISBN (Print)9784431555780
DOIs
Publication statusPublished - 2018 Jan 1

Fingerprint

Robotics
Rectal Neoplasms
Laparoscopy
Patient Positioning
Surgical Instruments
Dissection
Length of Stay
Urinary Bladder
Body Mass Index
Radiation
Psychology
Therapeutics

Keywords

  • Coloanal anastomosis
  • Intersphincteric resection
  • Rectal cancer
  • Robotic
  • Total mesorectal excision

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kwak, H. D., & Kim, S. H. (2018). Robot-assisted TME with coloanal anastomosis. In Surgical Techniques in Rectal Cancer: Transanal, Laparoscopic and Robotic Approach (pp. 289-310). Springer Japan. https://doi.org/10.1007/978-4-431-55579-7_18

Robot-assisted TME with coloanal anastomosis. / Kwak, Han Deok; Kim, Seon Hahn.

Surgical Techniques in Rectal Cancer: Transanal, Laparoscopic and Robotic Approach. Springer Japan, 2018. p. 289-310.

Research output: Chapter in Book/Report/Conference proceedingChapter

Kwak, HD & Kim, SH 2018, Robot-assisted TME with coloanal anastomosis. in Surgical Techniques in Rectal Cancer: Transanal, Laparoscopic and Robotic Approach. Springer Japan, pp. 289-310. https://doi.org/10.1007/978-4-431-55579-7_18
Kwak HD, Kim SH. Robot-assisted TME with coloanal anastomosis. In Surgical Techniques in Rectal Cancer: Transanal, Laparoscopic and Robotic Approach. Springer Japan. 2018. p. 289-310 https://doi.org/10.1007/978-4-431-55579-7_18
Kwak, Han Deok ; Kim, Seon Hahn. / Robot-assisted TME with coloanal anastomosis. Surgical Techniques in Rectal Cancer: Transanal, Laparoscopic and Robotic Approach. Springer Japan, 2018. pp. 289-310
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