Robotic Transanal Surgery for Rectal Cancer

Abstract

Robotic transanal surgery is the culmination of major developments in rectal cancer management and minimally invasive surgery. It is the result of continuous efforts to tackle the challenges inherent to rectal cancer surgery. This latest technology holds great promise and excitement for the care of the rectal cancer patient. In this article, we will describe the evolution of transanal rectal cancer surgery and describe how the convergence of transanal transabdominal, transanal endoscopic microsurgery, transanal minimally invasive surgery (TAMIS), transanal total mesorectal excision (taTME), and the different robotic platforms have culminated in the development of single port robotic transanal minimally invasive surgery (SP rTAMIS) and single port robotic transanal total mesorectal excision (SP rtaTME). We will describe the indications, technical aspects, outcomes, benefits, and limitations of the SP rTAMIS and SP rtaTME.

Keywords

robotic surgery - TATA - TEM - TAMIS - taTME - rectal cancer

Publikationsverlauf

Artikel online veröffentlicht:
09. September 2021

• References

• 1 Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart AK. Revised TN categorization for colon cancer based on national survival outcomes data. J Clin Oncol 2010; 28 (02) 264-271
• 2 Kim MN, Kang JM, Yang JI. et al. Clinical features and prognosis of early colorectal cancer treated by endoscopic mucosal resection. J Gastroenterol Hepatol 2011; 26 (11) 1619-1625
• 3 Kikuchi R, Takano M, Takagi K. et al. Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum 1995; 38 (12) 1286-1295
• 4 Sengupta S, Tjandra JJ. Local excision of rectal cancer: what is the evidence?. Dis Colon Rectum 2001; 44 (09) 1345-1361
• 5 Benson III AB, Bekaii-Saab T, Chan E. et al. Rectal cancer. J Natl Compr Canc Netw 2012; 10 (12) 1528-1564
• 6 Marks G, Mohiuddin M, Masoni L, Montori A. High-dose preoperative radiation as the key to extending sphincter-preservation surgery for cancer of the distal rectum. Surg Oncol Clin N Am 1992; 1: 71-86
• 7 Lezoche E, Baldarelli M, Lezoche G, Paganini AM, Gesuita R, Guerrieri M. Randomized clinical trial of endoluminal locoregional resection versus laparoscopic total mesorectal excision for T2 rectal cancer after neoadjuvant therapy. Br J Surg 2012; 99 (09) 1211-1218
• 8 Winde G, Nottberg H, Keller R, Schmid KW, Bünte H. Surgical cure for early rectal carcinomas (T1). Transanal endoscopic microsurgery vs. anterior resection. Dis Colon Rectum 1996; 39 (09) 969-976
• 9 Buess G, Theiss R, Günther M, Hutterer F, Pichlmaier H. Transanal endoscopic microsurgery. Leber Magen Darm 1985; 15 (06) 271-279
• 10 Rai V, Mishra N. Transanal approach to rectal polyps and cancer. Clin Colon Rectal Surg 2016; 29 (01) 65-70
• 11 Neary P, Makin GB, White TJ. et al. Transanal endoscopic microsurgery: a viable operative alternative in selected patients with rectal lesions. Ann Surg Oncol 2003; 10 (09) 1106-1111
• 12 Atallah S, Albert M, Larach S. Transanal minimally invasive surgery: a giant leap forward. Surg Endosc 2010; 24 (09) 2200-2205
• 13 Rimonda R, Arezzo A, Arolfo S, Salvai A, Morino M. TransAnal minimally invasive surgery (TAMIS) with SILS™ port versus transanal endoscopic microsurgery (TEM): a comparative experimental study. Surg Endosc 2013; 27 (10) 3762-3768
• 14 Marks JH, Frenkel JL, D'Andrea AP, Greenleaf CE. Maximizing rectal cancer results: TEM and TATA techniques to expand sphincter preservation. Surg Oncol Clin N Am 2011; 20 (03) 501-520 , viii–ix viii–ix
• 15 Atallah SB, Albert MR, deBeche-Adams TH, Larach SW. Robotic TransAnal minimally invasive surgery in a cadaveric model. Tech Coloproctol 2011; 15 (04) 461-464
• 16 Atallah S, Parra-Davila E, DeBeche-Adams T, Albert M, Larach S. Excision of a rectal neoplasm using robotic transanal surgery (RTS): a description of the technique. Tech Coloproctol 2012; 16 (05) 389-392
• 17 Tomassi MJ, Taller J, Yuhan R, Ruan JH, Klaristenfeld DD. Robotic transanal minimally invasive surgery for the excision of rectal neoplasia: clinical experience with 58 consecutive patients. Dis Colon Rectum 2019; 62 (03) 279-285
• 18 Atallah S, Nassif G, Polavarapu H. et al. Robotic-assisted transanal surgery for total mesorectal excision (RATS-TME): a description of a novel surgical approach with video demonstration. Tech Coloproctol 2013; 17 (04) 441-447
• 19 Hompes R, Rauh SM, Ris F, Tuynman JB, Mortensen NJ. Robotic transanal minimally invasive surgery for local excision of rectal neoplasms. Br J Surg 2014; 101 (05) 578-581
• 20 Atallah S, Martin-Perez B, Parra-Davila E. et al. Robotic transanal surgery for local excision of rectal neoplasia, transanal total mesorectal excision, and repair of complex fistulae: clinical experience with the first 18 cases at a single institution. Tech Coloproctol 2015; 19 (07) 401-410
• 21 Gómez Ruiz M, Parra IM, Palazuelos CM. et al. Robotic-assisted laparoscopic transanal total mesorectal excision for rectal cancer: a prospective pilot study. Dis Colon Rectum 2015; 58 (01) 145-153
• 22 van der Schans EM, Hiep MAJ, Consten ECJ, Broeders IAMJ. From Da Vinci Si to Da Vinci Xi: realistic times in draping and docking the robot. J Robot Surg 2020; 14 (06) 835-839
• 23 Marks G, Mohiuddin M, Goldstein SD. Sphincter preservation for cancer of the distal rectum using high dose preoperative radiation. Int J Radiat Oncol Biol Phys 1988; 15 (05) 1065-1068
• 24 Kim JG, Heo YJ, Son GM. et al. Impact of laparoscopic surgery on the long-term outcomes for patients with rectal cancer. ANZ J Surg 2009; 79 (11) 817-823
• 25 Marks G, Bannon J, Marks J. Transanal-abdominal transanal radical proctosigmoidectomy with coloanal anastomosis for distal rectal cancer. In: Baker R, Fisher J, Nyhus L. eds. Mastery of Surgery. 3rd ed.. Boston, MA: Little, Brown and Company Inc.; 1996: 1524-1534
• 26 Marks JH, Myers EA, Zeger EL, Denittis AS, Gummadi M, Marks GJ. Long-term outcomes by a transanal approach to total mesorectal excision for rectal cancer. Surg Endosc 2017; 31 (12) 5248-5257
• 27 Marks JH, Salem JF, Valsdottir EB, Yarandi SS, Marks GJ. Quality of life and functional outcome after transanal abdominal transanal proctectomy for low rectal cancer. Dis Colon Rectum 2017; 60 (03) 258-265
• 28 Leroy J, Barry BD, Melani A, Mutter D, Marescaux J. No-scar transanal total mesorectal excision: the last step to pure NOTES for colorectal surgery. JAMA Surg 2013; 148 (03) 226-230 , discussion 231
• 29 Chouillard E, Chahine E, Khoury G. et al. NOTES total mesorectal excision (TME) for patients with rectal neoplasia: a preliminary experience. Surg Endosc 2014; 28 (11) 3150-3157
• 30 Marks JH, Lopez-Acevedo N, Krishnan B, Johnson MN, Montenegro GA, Marks GJ. True NOTES TME resection with splenic flexure release, high ligation of IMA, and side-to-end hand-sewn coloanal anastomosis. Surg Endosc 2016; 30 (10) 4626-4631
• 31 Salem J, Marks JH. Transanal laparoscopic TME with Robot-Assisted Abdominal laparoscopy. In: Dapri G, Marks J. eds. Surgical Techniques in Rectal Cancer. Tokyo: Springer; 2018