Division of Colorectal Surgery, Department of Surgery, South Korea University Anam Hospital, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul, 02841, South Korea.
Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, The University of Sydney Westmead Clinical School, Sydney, NSW, Australia.
Tech Coloproctol. 2017 Nov;21(11):893-895. doi: 10.1007/s10151-017-1709-6. Epub 2017 Nov 13.
Total robotic resection of mid- and low rectal cancers confers technical advantages within the confines of the pelvis and allows difficult rectal cancer cases to be performed efficiently with less risk of conversion to open. To maximize the advantage of robotic surgery, we utilize the technique of single docking totally robotic dissection for rectal cancer for both the Da Vinci Si and Xi Surgical Systems. All steps are performed robotically, with the surgery divided into two phases. The first phase consists of inferior mesenteric artery and vein ligation, sigmoid and descending colon mobilization and splenic flexure takedown. Phase two is rectal dissection and pelvic total mesorectal excision. In this article, which is complemented by a video, we describe in detail our surgical technique for totally robotic dissection for rectal cancer using a standardized 'medial to lateral' approach with emphasis on the pearls and pitfalls of this surgery.
全机器人中低位直肠癌切除术在盆腔范围内具有技术优势，可有效地完成困难的直肠癌病例，降低中转开放的风险。为了最大限度地发挥机器人手术的优势，我们在达芬奇 Si 和 Xi 手术系统上都采用了单 docking 全机器人直肠肿瘤切除术的技术。所有步骤均采用机器人操作，手术分为两个阶段。第一阶段包括肠系膜下动静脉结扎、乙状结肠和降结肠游离以及脾曲游离。第二阶段是直肠游离和盆腔全直肠系膜切除。本文通过视频详细介绍了我们使用标准化的“从内侧到外侧”入路的全机器人直肠肿瘤游离术的手术技术，重点介绍了该手术的要点和难点。
