Ann Surg Treat Res.  2022 Jul;103(1):1-11. 10.4174/astr.2022.103.1.1.

Current status and role of robotic approach in patients with low-lying rectal cancer

• Ryu HS
• Kim J

• KMID: 2531142
• DOI: http://doi.org/10.4174/astr.2022.103.1.1

Abstract

Utilization of robotic surgical systems has increased over the years. Robotic surgery is presumed to have advantages of enhanced visualization, improved dexterity, and reduced tremor, which is purported to be more suitable for rectal cancer surgery in a confined space than laparoscopic or open surgery. However, evidence supporting improved clinical and oncologic outcomes after robotic surgery remains controversial and limited despite the widespread adoption of robotic surgical systems. To date, numerous observational studies and a few randomized controlled trials have failed to demonstrate that short-term, oncological, and functional outcomes after a robotic surgery are superior to those of laparoscopic surgery for low rectal cancer patients. The objective of this review is to summarize the current state of robotic surgery and its impact on low-lying rectal cancer.  

Keyword

Minimally invasive surgical procedures; Proctectomy; Rectal neoplasms; Robotic surgical procedures; Treatment outcome

Figure

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  Fig. 1 The da Vinci Xi robotic system (Intuitive Surgical Inc., Sunnyvale, CA, USA) with robotic arms docked.

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  Fig. 2 Total mesorectal excision in robotic surgery. (A) Posterior dissection of mesorectum. (B) Anterior dissection exposing Denonvillier’s fascia and seminal vesicle. (C) Deep pelvic view. Pelvic floor muscles are exposed clearly.

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  Fig. 3 Robotic lateral pelvic lymph node dissection. Stable constant traction provides safe dissection of the lateral pelvic wall.

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  Fig. 4 Robotic intersphincteric resection. The surgical plane between the rectum and puborectalis muscle is developed.

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