Single-stage totally robotic dissection for rectal cancer surgery

Technique and short-term outcome in 50 consecutive patients

Dong Jin Choi, Seon Hahn Kim, Peter J.M. Lee, Jin Kim, Si Uk Woo

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

Purpose: To overcome the pitfalls of laparoscopy, a robotic system has been introduced in rectal cancer surgery. However, there is no standard procedure to maximize the advantages of the da Vinci™ S Surgical System. Therefore, we describe our technique of applying the robotic system during all of the steps of dissection in rectal cancer surgery and the short-term outcome. METHODS: Prospectively collected data were reviewed from 50 consecutive patients who underwent single- stage, totally robotic dissection for rectal cancer resection between July 2007 and June 2008. Robotic dissection was performed following these steps: 1) ligation of the inferior mesenteric vessels and medial to lateral dissection, 2) mobilization of the sigmoid/descending/splenic flexure colon, and 3) rectal dissection. The remaining steps including rectal transection and anastomosis were performed by a conventional laparoscopic method. RESULTS: There were 32 (64%) men and 18 (36%) women. The mean distance from the anal verge to the tumor margin was 7.3 (range, 2-13) cm. The conversion rate was 0%. The mean operative time was 304.8 (range, 190-485) minutes, and 20.6 (range, 6-48) lymph nodes were harvested. The circumferential margin was positive in one patient. The length of hospital stay after surgery was 9.2 (range, 5-24) days. Anastomotic leak rate was 8.3%, and all of the patients with leakage were managed conservatively. CONCLUSIONS: Single-stage robotic dissection for rectal cancer surgery is feasible, and its short-term outcome is acceptable. Our technique can be a suitable procedure to maximize the advantages of the da Vinci™ system.

Original languageEnglish
Pages (from-to)1824-1830
Number of pages7
JournalDiseases of the Colon and Rectum
Volume52
Issue number11
DOIs
Publication statusPublished - 2009 Nov 1

Fingerprint

Robotics
Rectal Neoplasms
Dissection
Length of Stay
Transverse Colon
Anastomotic Leak
Sigmoid Colon
Operative Time
Laparoscopy
Ligation
Colon
Lymph Nodes
Neoplasms

Keywords

  • Rectal cancer
  • Rectal surgery
  • Robotics

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Single-stage totally robotic dissection for rectal cancer surgery : Technique and short-term outcome in 50 consecutive patients. / Choi, Dong Jin; Kim, Seon Hahn; Lee, Peter J.M.; Kim, Jin; Woo, Si Uk.

In: Diseases of the Colon and Rectum, Vol. 52, No. 11, 01.11.2009, p. 1824-1830.

Research output: Contribution to journalArticle

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