Totally robotic versus totally laparoscopic surgery for rectal cancer

Abstract

Heald and Ryall introduced surgical techniques consisting of the complete removal of the mesorectum, which was named total mesorectal excision (TME) in the 1980s. The main outcome that could be achieved in the surgical treatment of rectal cancer is obtaining a good quality mesorectal excision besides enough harvested lymph nodes. TME reduces the risk of local recurrence and improves survival in patients with mid and low rectal disease. Many studies have indicated that minimally invasive surgery provides a faster postoperative recovery and a lower complication rate compared to conventional surgery. Ever since laparoscopic colectomy was done in 1991, its volume has increased over the last 30 years. In 2002 the first robotic-assisted colectomy article was published and in 2006 the first robotic-assisted TME article was published. After a learning curve for robotic surgery, it could be possible complete TME for oncological outcomes. Many studies have shown that there were no differences in terms of surgical and oncological outcomes between robotic and laparoscopic methods in rectal surgery. The aim of this video presentation study is to report the technical details of laparoscopic and robotic approaches for rectal cancer surgery and to state the similarities and differences between these two methods.