Yan-Jiun Huang1, Yu-Min Huang2, Wei-Lin Wang3, Yiu-Shun Tong3, Wayne Hsu3, Po-Li Wei4. 1. Department of Surgery, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan. 2. Department of Surgery, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Gastrointestinal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan. 3. Division of Trauma, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan. 4. Department of Surgery, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Cancer Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Translational Laboratory, Department of Medical Research, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Cancer Biology and Drug Discovery, Taipei Medical University, Taipei, Taiwan. Electronic address: poliwei@tmu.edu.tw.
Abstract
BACKGROUND: Rectal neoplasm is one of the most common malignancies worldwide. Screening programs for rectal neoplasm result in early diagnosis and a decrease in disease-related mortality and morbidity. In selected patients, early rectal cancer may be treated with local excision. Owing to poor exposure during conventional transanal excision, transanal minimally invasive surgery (TAMIS) was developed, and TAMIS is feasible for the local excision of selected rectal neoplasms. However, the limited range of motion is a major disadvantage of this operation. Therefore, robotic TAMIS was developed to resolve this issue. This paper describes the surgical outcomes of robotic TAMIS for selected rectal tumors. METHODS: The eligibility criteria for robotic TAMIS were as follows: benign neoplasms, early malignancy, complete remission after concurrent chemoradiotherapy, lesions located in the middle or lower rectum, and a lesion size of less than 5 cm. To gain access to the anal canal, a transanal access platform was used, and the da Vinci robotic system was mounted for surgery. Patient characteristics and surgical outcomes were recoded. RESULTS: A total of 23 patients were included, and the median tumor size was 2.5 cm (range: 1.1-4.5 cm) on average. The median tumor location was 5 cm (range: 2-8 cm) from the anal verge. The median length of hospital stay was 3 days (range: 1-10 days). No intraoperative complications were reported, and no patient readmission occurred. The median follow-up period was 9.6 months. No recurrent lesion was found in the follow-up period. CONCLUSION: Based on the short-term results, robotic TAMIS is a feasible and safe technique for the local excision of selected rectal neoplasms.
BACKGROUND:Rectal neoplasm is one of the most common malignancies worldwide. Screening programs for rectal neoplasm result in early diagnosis and a decrease in disease-related mortality and morbidity. In selected patients, early rectal cancer may be treated with local excision. Owing to poor exposure during conventional transanal excision, transanal minimally invasive surgery (TAMIS) was developed, and TAMIS is feasible for the local excision of selected rectal neoplasms. However, the limited range of motion is a major disadvantage of this operation. Therefore, robotic TAMIS was developed to resolve this issue. This paper describes the surgical outcomes of robotic TAMIS for selected rectal tumors. METHODS: The eligibility criteria for robotic TAMIS were as follows: benign neoplasms, early malignancy, complete remission after concurrent chemoradiotherapy, lesions located in the middle or lower rectum, and a lesion size of less than 5 cm. To gain access to the anal canal, a transanal access platform was used, and the da Vinci robotic system was mounted for surgery. Patient characteristics and surgical outcomes were recoded. RESULTS: A total of 23 patients were included, and the median tumor size was 2.5 cm (range: 1.1-4.5 cm) on average. The median tumor location was 5 cm (range: 2-8 cm) from the anal verge. The median length of hospital stay was 3 days (range: 1-10 days). No intraoperative complications were reported, and no patient readmission occurred. The median follow-up period was 9.6 months. No recurrent lesion was found in the follow-up period. CONCLUSION: Based on the short-term results, robotic TAMIS is a feasible and safe technique for the local excision of selected rectal neoplasms.
Authors: Nik Dekkers; Hao Dang; Jolein van der Kraan; Saskia le Cessie; Philip P Oldenburg; Jan W Schoones; Alexandra M J Langers; Monique E van Leerdam; Jeanin E van Hooft; Yara Backes; Katarina Levic; Alexander Meining; Giorgio M Saracco; Fabian A Holman; Koen C M J Peeters; Leon M G Moons; Pascal G Doornebosch; James C H Hardwick; Jurjen J Boonstra Journal: Surg Endosc Date: 2022-06-30 Impact factor: 4.584