Robotic assisted low anterior resection for rectal cancers

Abstract

Laparoscopic colectomy for colon cancer is a well-recognized procedure nowadays. It has the benefit of minimizing surgical trauma. Although it has now been well adopted in many centres, a similar transition from open to laparoscopic resection for low rectal cancers has only occurred in limited centres. The main hurdle is the complexity of performing oncological sound minimal invasive surgery in a narrow confined pelvic cavity. The preservation of genitourinary function added further challenge. The use of robotics opens a new page in rectal cancer surgery. It overcomes the inherent limitations of conventional laparoscopic method. It provides a stable ergonomic platform for the surgeon to operate. It has a 3-dimensional view of the operating field. Surgeon can control three robotic arms with ultra-flexible articulating instruments. The robotic arms also provide excellent countertraction. Contrast to the conventional laparoscopic rectal surgery, the operating surgeon can site comfortably at the console and perform most of the dissection without much struggling. This presentation would discuss the application of robotics in rectal cancer surgery. It would focus on how the use of robotic system helps to facilitate dissection to achieve total mesorectal excision and preserve the nearby neurovascular structures. It would also discuss on performing sphincter-saving procedure in ultralow rectal cancers. The learning curve and initial results of robotic assisted rectal resection would also be presented.