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Robotic Rectal Resection

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Rectal Cancer

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Abstract

The short-term benefits of minimally invasive laparoscopic colectomy for colon cancer are advantageous compared to open resection and include speedier recovery time, briefer hospital stay, decreased need for analgesic medication, and better cosmesis. For these reasons, the adoption of laparoscopic techniques in the surgical treatment of colon cancer has accelerated over the past decade. However, laparoscopic approaches to rectal cancer surgery have not had the same popularity. This may be due to the increased technical demands of pelvic surgery and the limitations imposed by the straight, rigid laparoscopic instrumentation, with corresponding ergonomic disadvantages for the operating surgeon. High rates of conversion have moved surgeons to develop hybrid procedures, in which the difficult pelvic portion of the operation is performed via a low Pfannenstiel incision (Moloo et al., Cochrane Database Syst Rev (10):CD006585, 2010) or even a transanal approach (Lacy et al., Surg Endosc 27(1):339046, 2013). As a result, the adoption of laparoscopy in rectal resection has been low. The robotic platform helps overcome many of the limitations of standard laparoscopy. In this chapter, we discuss the current evidence supporting the use of robotic technology in rectal cancer surgery. We also provide a description of the technique, including ways to avoid common pitfalls.

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Abbreviations

3-D:

Three dimensional

ACOSOG:

American College of Surgeons Oncology Group

COLOR II trial:

Color carcinoma laparoscopic or open trial

COREAN trial:

Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy

CRM:

Circumferential resection margin

MRC CLASSICC trial:

Conventional versus laparoscopic-assisted surgery in patients with colorectal cancer

ROLARR trial:

Robotic vs. laparoscopic resection for rectal cancer

TME:

Total mesorectal excision

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Authors and Affiliations

  1. Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Sunil Patel & Martin R. Weiser

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  1. Sunil Patel
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  2. Martin R. Weiser
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Correspondence to Martin R. Weiser .

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Editors and Affiliations

  1. Department of Surgical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA

    George J. Chang

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Patel, S., Weiser, M.R. (2018). Robotic Rectal Resection. In: Chang, G. (eds) Rectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-16384-0_10

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  • DOI: https://doi.org/10.1007/978-3-319-16384-0_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-16383-3

  • Online ISBN: 978-3-319-16384-0

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