title: Robotic total mesorectal excision for rectal cancer using four robotic arms.
abstract: BACKGROUND
  The da Vinci system is a newly developed device for colorectal surgery, therefore experience of its use for rectal cancer surgery is limited and there are no reports describing the use of four robotic arms with this system. The aim of this study is to evaluate the safety and feasibility of the four-arm da Vinci system for total mesorectal excision in rectal cancer patients.
  
  
  METHODS
  Clinicopathologic data were prospectively collected on nine patients who underwent robotic total mesorectal excision using four robotic arms for the treatment of mid or low rectal cancer between November 2006 and Febuary 2007. Patient demographics, perioperative clinical outcomes, and pathology results with macroscopic grading (complete, nearly complete, incomplete) were evaluated.
  
  
  RESULTS
  nine patients with mid or low rectal cancer underwent robotic total mesorectal excison using four robotic arms without serious complications. The mean length of hospital stay was 7.4 +/- 1.3 days (range 5.0-10.0 days) and the mean operating time was 220.8 +/- 49.4 min (range 153-315 min). Macroscopic grading of the specimen was complete in eight patients and nearly complete in one patient. There were no cases of conversion.
  
  
  CONCLUSIONS
  In the present study, we accomplished nine robot-assisted rectal resections safely and effectively.
authors.affiliation: Robotic and Laparoscopic Surgery Center, Severance Hospital, Seoul, Korea. whitenoja@yumc.yonsei.ac.kr
authors.forename: Seung Hyuk
authors.initials: SH
authors.lastname: Baik
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
authors.forename: Koon Ho
authors.initials: KH
authors.lastname: Rha
authors.forename: Nam Kyu
authors.initials: NK
authors.lastname: Kim
authors.forename: Seung Kook
authors.initials: SK
authors.lastname: Sohn
authors.forename: Hoon Sang
authors.initials: HS
authors.lastname: Chi
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Cho
authors.forename: Sang Kil
authors.initials: SK
authors.lastname: Lee
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Cheon
authors.forename: Joong Bae
authors.initials: JB
authors.lastname: Ahn
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Kim
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011351:Proctoscopy / Q000379:methods*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012371:Robotics; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome