Preclinical cadaveric study of transanal robotic proctectomy with total mesorectal excision combined with laparoscopic assistance

Int J Med Robot. 2015 Jun;11(2):188-93. doi: 10.1002/rcs.1581. Epub 2014 Feb 27.

Abstract

Background: Anterior resection with total mesorectal excision (TME) is the standard method of rectal cancer resection. However, this procedure remains technically difficult. A robotic transanal approach could overcome some of these limitations. An initial laboratory experience with robotic transanal TME using a new designed port on human cadavers is reported.

Methods: The feasibility of robotic transanal TME and ideal set-up were evaluated in human cadavers. For the da Vinci Si HD system transanal access and total mesorectal excision, a specifically designed port was used.

Results: It was possible to complete a proctectomy with transanal total mesorectal excision. The port proved to be very reliable and facilitated docking of the robotic arms.

Conclusion: Using the robotic technology and a specifically designed port for robotic transanal access, TME was shown to be feasible and one specific preferred set-up was determined. Further clinical trials will be necessary to assess the safety and efficacy of this technique.

Keywords: rectal cancer; robotic surgery; transanal.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anal Canal / anatomy & histology
  • Anal Canal / surgery
  • Cadaver
  • Digestive System Surgical Procedures / instrumentation
  • Digestive System Surgical Procedures / methods*
  • Equipment Design
  • Feasibility Studies
  • Female
  • Humans
  • Laparoscopy / instrumentation
  • Laparoscopy / methods
  • Male
  • Models, Anatomic
  • Natural Orifice Endoscopic Surgery / instrumentation
  • Natural Orifice Endoscopic Surgery / methods
  • Rectal Neoplasms / surgery*
  • Rectum / anatomy & histology
  • Rectum / surgery
  • Robotic Surgical Procedures / instrumentation
  • Robotic Surgical Procedures / methods*