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06-01-2015 | Colorectal cancer | Article

Robotic Surgery for Colon and Rectal Cancer

Journal: Current Oncology Reports

Authors: Eun Jung Park, Seung Hyuk Baik

Abstract

Robotic surgery, used generally for colorectal cancer, has the advantages of a three-dimensional surgical view, steadiness, and seven degrees of robotic arms. However, there are disadvantages, such as a decreased sense of touch, extra time needed to dock the robotic cart, and high cost. Robotic surgery is performed using various techniques, with or without laparoscopic surgery. Because the results of this approach are reported to be similar to or less favorable than those of laparoscopic surgery, the learning curve for robotic colorectal surgery remains controversial. However, according to short- and long-term oncologic outcomes, robotic colorectal surgery is feasible and safe compared with conventional surgery. Advanced technologies in robotic surgery have resulted in favorable intraoperative and perioperative clinical outcomes as well as functional outcomes. As the technical advances in robotic surgery improve surgical performance as well as outcomes, it increasingly is being regarded as a treatment option for colorectal surgery. However, a multicenter, randomized clinical trial is needed to validate this approach.

Weber PA, Merola S, Wasielewski A, Ballantyne GH. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum. 2002;45(12):1689–94. doi:10.1097/01.dcr.0000037657.78153.a8. discussion 95–6.CrossRefPubMed

Hashizume M, Shimada M, Tomikawa M, Ikeda Y, Takahashi I, Abe R, et al. Early experiences of endoscopic procedures in general surgery assisted by a computer-enhanced surgical system. Surg Endosc. 2002;16(8):1187–91. doi:10.1007/s004640080154.CrossRefPubMed

D’Annibale A, Morpurgo E, Fiscon V, Trevisan P, Sovernigo G, Orsini C, et al. Robotic and laparoscopic surgery for treatment of colorectal diseases. Dis Colon Rectum. 2004;47(12):2162–8. doi:10.1007/s10350-004-0711-z.CrossRefPubMed

Pigazzi A, Ellenhorn JD, Ballantyne GH, Paz IB. Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer. Surg Endosc. 2006;20(10):1521–5. doi:10.1007/s00464-005-0855-5.CrossRefPubMed

Kim JY, Kim NK, Lee KY, Hur H, Min BS, Kim JH. A comparative study of voiding and sexual function after total mesorectal excision with autonomic nerve preservation for rectal cancer: laparoscopic versus robotic surgery. Ann Surg Oncol. 2012;19(8):2485–93. doi:10.1245/s10434-012-2262-1.CrossRefPubMed

Baek SJ, Kim CH, Cho MS, Bae SU, Hur H, Min BS, et al. Robotic surgery for rectal cancer can overcome difficulties associated with pelvic anatomy. Surg Endosc. 2015;29(6):1419–24. doi:10.1007/s00464-014-3818-x.CrossRefPubMed

7.••

Park EJ, Cho MS, Baek SJ, Hur H, Min BS, Baik SH, et al. Long-term oncologic outcomes of robotic low anterior resection for rectal cancer: a comparative study with laparoscopic surgery. Ann Surg. 2015;261(1):129–37. doi:10.1097/sla.0000000000000613. This article, the first to report the long-term oncologic outcomes of robotic low anterior resection for rectal cancer, discusses the oncologic perspectives and prognostic factors of robotic versus laparoscopic surgery for rectal cancer.CrossRefPubMed

Kim CW, Baik SH, Roh YH, Kang J, Hur H, Min BS, et al. Cost-effectiveness of robotic surgery for rectal cancer focusing on short-term outcomes: a propensity score-matching analysis. Medicine (Baltimore). 2015;94(22), e823. doi:10.1097/md.0000000000000823.CrossRef

Baek SJ, Kim SH, Cho JS, Shin JW, Kim J. Robotic versus conventional laparoscopic surgery for rectal cancer: a cost analysis from a single institute in Korea. World J Surg. 2012;36(11):2722–9. doi:10.1007/s00268-012-1728-4.CrossRefPubMed

10.

Baik SH, Lee WJ, Rha KH, Kim NK, Sohn SK, Chi HS, et al. Robotic total mesorectal excision for rectal cancer using four robotic arms. Surg Endosc. 2008;22(3):792–7. doi:10.1007/s00464-007-9663-4.CrossRefPubMed

11.

Prasad LM, Marecik SJ, Blumetti J, Park JJ, Zimmern A, Abcarian H. Total mesorectal excision for rectal cancer: the potential advantage of robotic assistance. Dis Colon Rectum. 2010;53(12):1611–7.CrossRefPubMed

12.

Park JS, Choi G-S, Lim KH, Jang YS, Jun SH. Robotic-assisted versus laparoscopic surgery for low rectal cancer: case-matched analysis of short-term outcomes. Ann Surg Oncol. 2010;17(12):3195–202.CrossRefPubMed

13.

Park YA, Kim JM, Kim SA, Min BS, Kim NK, Sohn SK, et al. Totally robotic surgery for rectal cancer: from splenic flexure to pelvic floor in one setup. Surg Endosc. 2010;24(3):715–20. doi:10.1007/s00464-009-0656-3.CrossRefPubMed

14.

Choi DJ, Kim SH, Lee PJ, Kim J, Woo SU. Single-stage totally robotic dissection for rectal cancer surgery: technique and short-term outcome in 50 consecutive patients. Dis Colon Rectum. 2009;52(11):1824–30. doi:10.1007/DCR.0b013e3181b13536.CrossRefPubMed

15.

Koh DC-S, Tsang CB-S, Kim S-H. A new application of the four-arm standard da Vinci® surgical system: totally robotic-assisted left-sided colon or rectal resection. Surg Endosc. 2011;25(6):1945–52.CrossRefPubMed

16.

Park J, You YN, Schlette E, Nguyen S, Skibber JM, Rodriguez-Bigas MA, et al. Reverse-hybrid robotic mesorectal excision for rectal cancer. Dis Colon Rectum. 2012;55(2):228.CrossRefPubMedPubMedCentral

17.•

Baik SH, Kim NK, Lim DR, Hur H, Min BS, Lee KY. Oncologic outcomes and perioperative clinicopathologic results after robot-assisted tumor-specific mesorectal excision for rectal cancer. Ann Surg Oncol. 2013;20(8):2625–32. doi:10.1245/s10434-013-2895-8. This article discusses the oncologic and perioperative outcomes of robotic surgery for rectal cancer, highlighting the short-term oncologic outcomes of the hybrid versus the totally robotic technique.CrossRefPubMed

18.

Diana M, Perretta S, Wall J, Costantino F, Leroy J, Demartines N, et al. Transvaginal specimen extraction in colorectal surgery: current state of the art. Color Dis. 2011;13(6):e104–e11.CrossRef

19.

Choi G-S, Park IJ, Kang BM, Lim KH, Jun S-H. A novel approach of robotic-assisted anterior resection with transanal or transvaginal retrieval of the specimen for colorectal cancer. Surg Endosc. 2009;23(12):2831–5.CrossRefPubMed

20.

Park JS, Choi G-S, Lim KH, Jang YS, Jun SH. S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancer. Surg Endosc. 2011;25(1):240–8.CrossRefPubMed

21.

Park EJ, Kim CW, Cho MS, Baik SH, Kim DW, Min BS, et al. Multidimensional analyses of the learning curve of robotic low anterior resection for rectal cancer: 3-phase learning process comparison. Surg Endosc. 2014;28(10):2821–31. doi:10.1007/s00464-014-3569-8.CrossRefPubMed

22.

Yamaguchi T, Kinugasa Y, Shiomi A, Sato S, Yamakawa Y, Kagawa H, et al. Learning curve for robotic-assisted surgery for rectal cancer: use of the cumulative sum method. Surg Endosc. 2015;29(7):1679–85. doi:10.1007/s00464-014-3855-5.CrossRefPubMed

23.

Kim HJ, Choi GS, Park JS, Park SY. Multidimensional analysis of the learning curve for robotic total mesorectal excision for rectal cancer: lessons from a single surgeon’s experience. Dis Colon Rectum. 2014;57(9):1066–74. doi:10.1097/dcr.0000000000000174.CrossRefPubMed

24.

Park EJ, Kim CW, Cho MS, Kim DW, Min BS, Baik SH, et al. Is the learning curve of robotic low anterior resection shorter than laparoscopic low anterior resection for rectal cancer?: a comparative analysis of clinicopathologic outcomes between robotic and laparoscopic surgeries. Medicine (Baltimore). 2014;93(25), e109. doi:10.1097/md.0000000000000109.CrossRef

25.

Sng KK, Hara M, Shin JW, Yoo BE, Yang KS, Kim SH. The multiphasic learning curve for robot-assisted rectal surgery. Surg Endosc. 2013;27(9):3297–307. doi:10.1007/s00464-013-2909-4.CrossRefPubMed

26.

Bokhari MB, Patel CB, Ramos-Valadez DI, Ragupathi M, Haas EM. Learning curve for robotic-assisted laparoscopic colorectal surgery. Surg Endosc. 2011;25(3):855–60. doi:10.1007/s00464-010-1281-x.CrossRefPubMedPubMedCentral

27.

Cho MS, Baek SJ, Hur H, Min BS, Baik SH, Lee KY, et al. Short and long-term outcomes of robotic versus laparoscopic total mesorectal excision for rectal cancer: a case-matched retrospective study. Medicine (Baltimore). 2015;94(11), e522. doi:10.1097/md.0000000000000522.CrossRef

28.

Park SY, Choi GS, Park JS, Kim HJ, Ryuk JP. Short-term clinical outcome of robot-assisted intersphincteric resection for low rectal cancer: a retrospective comparison with conventional laparoscopy. Surg Endosc. 2013;27(1):48–55. doi:10.1007/s00464-012-2405-2.CrossRefPubMed

29.

Yoo BE, Cho JS, Shin JW, Lee DW, Kwak JM, Kim J, et al. Robotic versus laparoscopic intersphincteric resection for low rectal cancer: comparison of the operative, oncological, and functional outcomes. Ann Surg Oncol. 2015;22(4):1219–25. doi:10.1245/s10434-014-4177-5.CrossRefPubMed

30.

Bianchi PP, Ceriani C, Locatelli A, Spinoglio G, Zampino MG, Sonzogni A, et al. Robotic versus laparoscopic total mesorectal excision for rectal cancer: a comparative analysis of oncological safety and short-term outcomes. Surg Endosc. 2010;24(11):2888–94. doi:10.1007/s00464-010-1134-7.CrossRefPubMed

31.

Baik SH, Kwon HY, Kim JS, Hur H, Sohn SK, Cho CH, et al. Robotic versus laparoscopic low anterior resection of rectal cancer: short-term outcome of a prospective comparative study. Ann Surg Oncol. 2009;16(6):1480–7. doi:10.1245/s10434-009-0435-3.CrossRefPubMed

32.

Xiong B, Ma L, Zhang C, Cheng Y. Robotic versus laparoscopic total mesorectal excision for rectal cancer: a meta-analysis. J Surg Res. 2014;188(2):404–14. doi:10.1016/j.jss.2014.01.027.CrossRefPubMed

33.

Wong MT, Meurette G, Rigaud J, Regenet N, Lehur PA. Robotic versus laparoscopic rectopexy for complex rectocele: a prospective comparison of short-term outcomes. Dis Colon Rectum. 2011;54(3):342–6. doi:10.1007/DCR.0b013e3181f4737e.CrossRefPubMed

34.

Park JS, Choi GS, Park SY, Kim HJ, Ryuk JP. Randomized clinical trial of robot-assisted versus standard laparoscopic right colectomy. Br J Surg. 2012;99(9):1219–26. doi:10.1002/bjs.8841.CrossRefPubMed

35.

Kim CW, Kim CH, Baik SH. Outcomes of robotic-assisted colorectal surgery compared with laparoscopic and open surgery: a systematic review. J Gastrointest Surg. 2014;18(4):816–30. doi:10.1007/s11605-014-2469-5.CrossRefPubMed

36.

Kim N-K, Kang J. Optimal total mesorectal excision for rectal cancer: the role of robotic surgery from an expert’s view. J Korean Soc Coloproctol. 2010;26(6):377–87.CrossRefPubMedPubMedCentral

37.

Baek JH, Pastor C, Pigazzi A. Robotic and laparoscopic total mesorectal excision for rectal cancer: a case-matched study. Surg Endosc. 2011;25(2):521–5. doi:10.1007/s00464-010-1204-x.CrossRefPubMed

38.

D’Annibale A, Pernazza G, Monsellato I, Pende V, Lucandri G, Mazzocchi P, et al. Total mesorectal excision: a comparison of oncological and functional outcomes between robotic and laparoscopic surgery for rectal cancer. Surg Endosc. 2013;27(6):1887–95. doi:10.1007/s00464-012-2731-4.CrossRefPubMed

39.

Park SY, Choi GS, Park JS, Kim HJ, Ryuk JP, Yun SH. Urinary and erectile function in men after total mesorectal excision by laparoscopic or robot-assisted methods for the treatment of rectal cancer: a case-matched comparison. World J Surg. 2014;38(7):1834–42. doi:10.1007/s00268-013-2419-5.CrossRefPubMed

40.

Morelli L, Ceccarelli C, Di Franco G, Guadagni S, Palmeri M, Caprili G et al. Sexual and urinary functions after robot-assisted versus pure laparoscopic total mesorectal excision for rectal cancer. Int J Colorectal Dis. 2015.

41.

Kim NK, Kim YW, Cho MS. Total mesorectal excision for rectal cancer with emphasis on pelvic autonomic nerve preservation: expert technical tips for robotic surgery. Surg Oncol. 2015.

42.

Broholm M, Pommergaard HC, Gogenur I. Possible benefits of robot-assisted rectal cancer surgery regarding urological and sexual dysfunction: a systematic review and meta-analysis. Color Dis. 2015;17(5):375–81. doi:10.1111/codi.12872.CrossRef

43.

Pigazzi A, Luca F, Patriti A, Valvo M, Ceccarelli G, Casciola L, et al. Multicentric study on robotic tumor-specific mesorectal excision for the treatment of rectal cancer. Ann Surg Oncol. 2010;17(6):1614–20.CrossRefPubMed

44.

Nagtegaal ID, van de Velde CJ, van der Worp E, Kapiteijn E, Quirke P, van Krieken JH. Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. J Clin Oncol. 2002;20(7):1729–34.CrossRefPubMed

45.

Hara M, Sng K, Yoo BE, Shin JW, Lee DW, Kim SH. Robotic-assisted surgery for rectal adenocarcinoma: short-term and midterm outcomes from 200 consecutive cases at a single institution. Dis Colon Rectum. 2014;57(5):570–7. doi:10.1097/dcr.0000000000000088.CrossRefPubMed

46.

Collinson FJ, Jayne DG, Pigazzi A, Tsang C, Barrie JM, Edlin R, et al. An international, multicentre, prospective, randomised, controlled, unblinded, parallel-group trial of robotic-assisted versus standard laparoscopic surgery for the curative treatment of rectal cancer. Int J Color Dis. 2012;27(2):233–41. doi:10.1007/s00384-011-1313-6.CrossRef

47.

Trastulli S, Desiderio J, Farinacci F, Ricci F, Listorti C, Cirocchi R, et al. Robotic right colectomy for cancer with intracorporeal anastomosis: short-term outcomes from a single institution. Int J Color Dis. 2013;28(6):807–14.CrossRef

48.

Mathew R, Kim S. Robotic right hemicolectomy with D3 lymphadenectomy and complete mesocolic excision: technical detail. OA Rob Surg. 2013;1(6).

49.

West NP, Hohenberger W, Weber K, Perrakis A, Finan PJ, Quirke P. Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol. 2010;28(2):272–8. doi:10.1200/jco.2009.24.1448.CrossRefPubMed

50.

Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation—technical notes and outcome. Color Dis. 2009;11(4):354–64. doi:10.1111/j.1463-1318.2008.01735.x. discussion 64–5.CrossRef

51.

Pappou EP, Weiser MR. Robotic colonic resection. Journal of Surgical Oncology. 2015

52.

Cho MS, Baek SJ, Hur H, Min BS, Baik SH, Kim NK. Modified complete mesocolic excision with central vascular ligation for the treatment of right-sided colon cancer: long-term outcomes and prognostic factors. Ann Surg. 2015;261(4):708–15.CrossRefPubMed

53.

Lim DR, Min BS, Kim MS, Alasari S, Kim G, Hur H, et al. Robotic versus laparoscopic anterior resection of sigmoid colon cancer: comparative study of long-term oncologic outcomes. Surg Endosc. 2013;27(4):1379–85. doi:10.1007/s00464-012-2619-3.CrossRefPubMedPubMedCentral

54.

Park EJ, Baik SH, Kang J, Hur H, Min BS, Lee KY et al. Short-term outcomes of the modified extralevator abdominoperineal resection for low rectal cancer (with videos). Surg Endosc. 2015:1–11.

55.

Bae SU, Saklani AP, Hur H, Min BS, Baik SH, Kim NK. Robotic interface for transabdominal division of the levators and pelvic floor reconstruction in abdominoperineal resection: a case report and technical description. Int J Med Robot. 2014. doi:10.1002/rcs.1624.PubMed

56.

Marecik SJ, Zawadzki M, Desouza AL, Park JJ, Abcarian H, Prasad LM. Robotic cylindrical abdominoperineal resection with transabdominal levator transection. Dis Colon Rectum. 2011;54(10):1320–5. doi:10.1097/DCR.0b013e31822720a2.CrossRefPubMed

57.

Shin JW, Kim J, Kwak JM, Hara M, Cheon J, Kang SH, et al. First report: robotic pelvic exenteration for locally advanced rectal cancer. Color Dis. 2014;16(1):O9–14. doi:10.1111/codi.12446.CrossRef

58.

Bae SU, Min BS, Kim NK. Robotic low ligation of the inferior mesenteric artery for rectal cancer using the Firefly technique. Yonsei Med J. 2015;56(4):1028–35. doi:10.3349/ymj.2015.56.4.1028.CrossRefPubMedPubMedCentral

59.

Bae SU, Baek SJ, Hur H, Baik SH, Kim NK, Min BS. Intraoperative near infrared fluorescence imaging in robotic low anterior resection: three case reports. Yonsei Med J. 2013;54(4):1066–9. doi:10.3349/ymj.2013.54.4.1066.CrossRefPubMedPubMedCentral

60.

Bae SU, Jeong WK, Bae OS, Baek SK. Reduced-port robotic anterior resection for left-sided colon cancer using the da Vinci single-site platform. Int J Med Robot. 2015. doi:10.1002/rcs.1677.PubMed

Medicine Matters Oncology

Abstract