Robotic total mesorectal excision

Abstract

Surgical robotics is particularly beneficial in surgery for lower rectal cancer, which is mainly performed deep within the narrow pelvic cavity. Since optimal tension can be maintained between tissues to clearly expose the dissectable layer using this modality, destruction of the mesorectum surrounding rectal cancer and lymph nodes can be avoided. Furthermore, robot-assisted surgery allows total mesorectal excision to be performed, ensuring preservation of the autonomic nervous system responsible for urinary and sexual functions. Another advantage of robot-assisted surgery is that suture and ligation can be performed easily deep in the narrow space. With the single-stapling technique, transection of the rectum and anastomosis can be performed in the deep narrow pelvis where the double-stapling technique would normally be technically challenging, thereby possibly avoiding unnecessary intersphincteric resection.