Recent advances in robotic surgery for rectal cancer

Ishihara, Soichiro; Otani, Kensuke; Yasuda, Koji; Nishikawa, Takeshi; Tanaka, Junichiro; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Hata, Keisuke; Kawai, Kazushige; Nozawa, Hiroaki; Kazama, Shinsuke; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji; Watanabe, Toshiaki

doi:10.1007/s10147-015-0854-z

Cited by 11 publications

(21 citation statements)

References 53 publications

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“…Robotic systems offer the advantages of: (i) a stable camera platform that is directly controlled by the surgeon; (ii) 3D stereoscopic vision with 10× magnification; and (iii) instruments with 7 degrees of movement, assisted by tremor‐filtering and motion‐scaling . These features potentially translate to better surgical outcomes in terms of preservation of neurological function, earlier return of bowel function, greater rates of negative resection margin, reduced fatigue of the surgeon, and lower conversion rates …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Insight into the da Vinci® Xi – technical notes for single‐docking left‐sided colorectal procedures

Ngu

Sim

Yusof

et al. 2016

Robotics Computer Surgery

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Section: Discussionmentioning

confidence: 99%

“…in 2002 . Since then, various authors have attempted to expound on the advantages of robotic surgery . Unfortunately, these benefits have to date been limited by issues such as prolonged docking time, operative duration, technical difficulties in multi‐quadrant access, and cost.…”

Section: Introductionmentioning

confidence: 99%

Insight into the da Vinci® Xi – technical notes for single‐docking left‐sided colorectal procedures

Ngu

Sim

Yusof

et al. 2016

Robotics Computer Surgery

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“…Robotic surgery has a number of benefits including flexible devices with seven degrees of free movement, stable three‐dimensional camera platforms and more precise surgical manipulation from tremor filtering and motion scaling . Baek et al .…”

Section: Discussionmentioning

confidence: 99%

“…stable three-dimensional camera platforms and more precise surgical manipulation from tremor filtering and motion scaling [59,60]. Baek et al have shown that RoTME may have advantages in a narrow pelvis or lowlying rectal cancer [61].…”

Section: Discussionmentioning

confidence: 99%

A comparison of open, laparoscopic and robotic total mesorectal excision: trial sequential analysis and network meta‐analysis

et al. 2019

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Aim Total mesorectal excision (TME) for rectal cancer can be achieved by employing open (OpTME), laparoscopic (LaTME) and robotic (RoTME) approaches but which of these has the best outcome? The aim of present study is to identify the most effective technique for rectal cancer by comparing all outcomes. Methods Randomized controlled trials (RCTs) which compared at least two TME strategies were identified by literature search of electronic databases of articles published to June 2018. Network meta‐analysis with trial sequential analysis was performed using a frequentist approach with random‐effects meta‐analysis. Data collection and analysisWe conducted a systematic search of PubMed, EmBase, the Cochrane Library, CNKI, and Web of Science. Titles and abstracts of the retrieved publications were independently and blindly assessed by two authors. Results Twenty‐two RCTs with 4882 rectal cancer patients were included in this analysis. The trial sequential analysis demonstrated that the cumulative Z‐curve crossed either the traditional boundary or the trial sequential monitoring boundaries, suggesting that OpTME resulted in a more complete TME specimen than LaTME (relative risk 1.05, 95% confidence interval 1.01–1.08). Network meta‐analysis showed there was no significant difference in the other comparisons. Based on the P score of completeness of the TME specimen and circumferential resection margin positivity, the best technique was OpTME, followed by RoTME and then LaTME. However, this order was reversed when complications and mortality were considered. RoTME led to better lymph node harvest. Conclusions Although OpTME may give better pathological specimens, minimally invasive techniques may have advantages when considering lymph node harvest, complications and mortality. More RCTs are needed to determine which technique actually gives the best chance of survival.

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“…As the pelvic autonomic nerves are outside the mesorectum, this technique also allows better preservation of the urinary and sexual functions. [10][11][12][13] Initially, during the 1980s, TME was performed by open surgery, which is still acceptable and commonly used in the treatment of rectal cancer. Currently, minimally invasive surgery techniques, such as laparoscopy and robotic surgery, are gaining popularity.…”

Section: Introductionmentioning

confidence: 99%

Robotic Surgery in Rectal Cancer

Oliveira

Barbosa

2021

Journal of Coloproctology

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Rectal cancer is an important cause of morbidity and mortality worldwide. The most effective and curative treatment is surgery, and the standard procedure is total mesorectal excision, initially performed by open surgery and posteriorly by minimally invasive techniques. Robotic surgery is an emerging technology that is expected to overcome the limitations of the laparoscopic approach. It has several advantages, including a stable camera platform with high definition three-dimensional image, flexible instruments with seven degrees of freedom, a third arm for fixed retraction, fine motion scaling, excellent dexterity, ambidextrous capability, elimination of physiological tremors and better ergonomics, that facilitate a steady and precise tissue dissection. The main technical disadvantages are the loss of tactile sensation and tensile feedback and the complex installation process. The aim of the present study is to review the importance and benefits of robotic surgery in rectal cancer, particularly in comparison with the laparoscopic approach. Intraoperative estimated blood loss, short and long-term outcomes as well as pathological outcomes were similar between robotic and laparoscopic surgery. The operative time is usually longer in robotic surgery and the high costs are still its major drawback. Robotic surgery for rectal cancer demonstrated lower conversion rate to open surgery and benefits in urinary and sexual functions and has been established as a safe and feasible technique.

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Recent advances in robotic surgery for rectal cancer

Cited by 11 publications

References 53 publications

Insight into the da Vinci® Xi – technical notes for single‐docking left‐sided colorectal procedures

Insight into the da Vinci® Xi – technical notes for single‐docking left‐sided colorectal procedures

A comparison of open, laparoscopic and robotic total mesorectal excision: trial sequential analysis and network meta‐analysis

Robotic Surgery in Rectal Cancer

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