Robotic Surgery for Rectal Cancer: Operative Technique and Review of the Literature.
Laparoscopic surgery
Lateral lymph node dissection
Mesorectal excision
Minimally invasive surgery
Rectal cancer
Robotic surgery
Journal
Journal of the anus, rectum and colon
ISSN: 2432-3853
Titre abrégé: J Anus Rectum Colon
Pays: Japan
ID NLM: 101718055
Informations de publication
Date de publication:
2020
2020
Historique:
received:
08
11
2019
accepted:
25
11
2019
entrez:
1
2
2020
pubmed:
1
2
2020
medline:
1
2
2020
Statut:
epublish
Résumé
The number of patients undergoing robotic surgery for rectal cancer has rapidly increased in Japan, since the government approved the procedure for national insurance coverage in April 2018. Robotic surgery has the potential to overcome some limitations of laparoscopic surgery, especially in the narrow pelvis, providing a three-dimensional view, articulated instruments, and a stable camera platform. Although meta-analyses and randomized controlled trials have failed to demonstrate the superiority of robotic surgery over laparoscopic surgery with respect to the short-term clinical outcomes, the published findings suggest that robotic surgery may be potentially beneficial for patients who are obese, male, or patients undergoing sphincter-preserving surgery for rectal cancer. The safety and feasibility of robotic surgery for lateral lymph node dissection, the standard procedure for locally advanced lower rectal cancer in Japan, have been demonstrated in some retrospective studies. However, additional prospective, randomized trials are required to determine the actual benefits of robotic surgery to ameliorate the urogenital and oncological outcomes. The cost of this approach is a long-standing principal concern. A literature search showed that the cost of robotic surgery for rectal cancer was 1.3-2.5 times higher per patient than that for the laparoscopic approach. We herein describe our surgical technique using a da Vinci Surgical System (S/Si/Xi) with 10 years of experience in performing robotic surgery. We also review current evidence regarding short-term clinical and long-term oncological outcomes, lateral lymph node dissection, and the cost of the procedure.
Identifiants
pubmed: 32002472
doi: 10.23922/jarc.2019-037
pmc: PMC6989125
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
14-24Informations de copyright
Copyright © 2020 by The Japan Society of Coloproctology.
Déclaration de conflit d'intérêts
Conflicts of Interest There are no conflicts of interest.
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