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Clin Colon Rectal Surg 2021; 34(05): 317-324
DOI: 10.1055/s-0041-1729864
Review Article

Robotic Transanal Surgery for Rectal Cancer

John H. Marks
1   Department of Colorectal Surgery, Lankenau Medical Center, Wynnewood, Pennsylvania
,
Rafael E. Perez
1   Department of Colorectal Surgery, Lankenau Medical Center, Wynnewood, Pennsylvania
,
Jean F. Salem
1   Department of Colorectal Surgery, Lankenau Medical Center, Wynnewood, Pennsylvania
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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


Publication History

Article published online:
09 September 2021

© 2021. Thieme. All rights reserved.

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  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 4 Sengupta S, Tjandra JJ. Local excision of rectal cancer: what is the evidence?. Dis Colon Rectum 2001; 44 (09) 1345-1361
    CrossrefPubMedGoogle Scholar
  • 5 Benson III AB, Bekaii-Saab T, Chan E. et al. Rectal cancer. J Natl Compr Canc Netw 2012; 10 (12) 1528-1564
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 9 Buess G, Theiss R, Günther M, Hutterer F, Pichlmaier H. Transanal endoscopic microsurgery. Leber Magen Darm 1985; 15 (06) 271-279
    PubMedGoogle Scholar
  • 10 Rai V, Mishra N. Transanal approach to rectal polyps and cancer. Clin Colon Rectal Surg 2016; 29 (01) 65-70
    Article in Thieme ConnectPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 12 Atallah S, Albert M, Larach S. Transanal minimally invasive surgery: a giant leap forward. Surg Endosc 2010; 24 (09) 2200-2205
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefGoogle Scholar