Verheijen P M, Consten E C J, Broeders I A M J
Department of General Surgery, Meander Medical Centre, Amersfoort, The Netherlands.
Int J Med Robot. 2014 Dec;10(4):423-6. doi: 10.1002/rcs.1594. Epub 2014 May 8.
A transanal approach for total mesorectal excision (TME) using a single incision port is feasible. The disadvantages are technical difficulties associated with limited manoeuvrability.
We present our first experience with robotic-assisted transanal total mesorectal excision. A 48 year-old woman with a tumour 8 cm from the anal verge was successfully operated using a transanal approach. A complete mesorectal excision was performed through a single incision port, using two robot arms.
TME was performed successfully and the patient recovered quickly without any complications. The histological report showed a complete mesorectal excision with free distal and circumferential margins. A sigmoidoscopy showed an intact anastomosis and the patient was planned for reversal of her ileostomy.
Transanal total mesorectal excision using the robot is feasible. Robotics may help to overcome technical difficulties associated with the single incision port.
采用单切口端口经肛门全直肠系膜切除术（TME）是可行的。其缺点是与操作灵活性受限相关的技术难题。
我们介绍了机器人辅助经肛门全直肠系膜切除术的首例经验。一名距肛缘8厘米处有肿瘤的48岁女性通过经肛门途径成功接受手术。使用两个机器人手臂通过单切口端口进行了完整的直肠系膜切除术。
成功实施了全直肠系膜切除术，患者恢复迅速且无任何并发症。组织学报告显示直肠系膜完整切除，远端和环周切缘阴性。乙状结肠镜检查显示吻合口完整，计划为患者回纳回肠造口。
使用机器人进行经肛门全直肠系膜切除术是可行的。机器人技术可能有助于克服与单切口端口相关的技术难题。
