title: Totally robotic surgery for rectal cancer: from splenic flexure to pelvic floor in one setup.
abstract: BACKGROUND
  Robotic surgery for rectal cancer may be a way to overcome the limitations of laparoscopic surgery. However, totally robotic surgery for rectal cancer is still technically challenging. This report describes the technical details and outcomes of totally robotic rectal surgery.
  
  
  METHODS
  The authors developed a totally robotic surgery technique for rectal cancer and performed it for 45 patients. We designed a six-port system, including a camera port, to perform rectal cancer surgery from the splenic flexure to the pelvic diaphragm in one setup. To check the feasibility and safety of the procedure, perioperative outcomes including conversion rate, morbidity, and mortality were analyzed.
  
  
  RESULTS
  The mean body mass index of the 45 patients was 23.6 kg/m(2) (range, 18.8-31.6 kg/m(2)). There was one case (2.2%) of conversion to laparotomy because of a common iliac artery injury. The 30-day morbidity rate was 11.1%. There was no operation-related mortality.
  
  
  CONCLUSIONS
  Totally robotic surgery for rectal cancer using the described technique was feasible and safe. This result could facilitate the spread of robotic surgery for rectal cancer and maximize the advantages of robotic surgery.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752 Seoul, Korea.
authors.forename: Yoon Ah
authors.initials: YA
authors.lastname: Park
authors.forename: Jung Man
authors.initials: JM
authors.lastname: Kim
authors.forename: Sung Ah
authors.initials: SA
authors.lastname: Kim
authors.forename: Byung Soh
authors.initials: BS
authors.lastname: Min
authors.forename: Nam Kyu
authors.initials: NK
authors.lastname: Kim
authors.forename: Seung Kook
authors.initials: SK
authors.lastname: Sohn
authors.forename: Kang Young
authors.initials: KY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044684:Colon, Transverse / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery*; D012371:Robotics / Q000295:instrumentation*; D016896:Treatment Outcome
references.citation: Surg Endosc. 2008 Mar;22(3):792-7
references.pmid: 18027033
references.citation: Ann Surg Oncol. 2007 Nov;14(11):3168-73
references.pmid: 17763911
references.citation: Br J Surg. 2005 Sep;92(9):1124-32
references.pmid: 15997446
references.citation: Surg Endosc. 2009 Feb;23(2):447-51
references.pmid: 19057962
references.citation: J Clin Oncol. 2007 Jul 20;25(21):3061-8
references.pmid: 17634484
references.citation: Ann Surg. 2004 Jan;239(1):14-21
references.pmid: 14685095
references.citation: Dis Colon Rectum. 2008 Nov;51(11):1627-32
references.pmid: 18484134
references.citation: Ann Surg. 2007 Oct;246(4):655-62; discussion 662-4
references.pmid: 17893502
references.citation: Dis Colon Rectum. 2002 Dec;45(12):1689-94; discussion 1695-6
references.pmid: 12473897
references.citation: Lancet Oncol. 2009 Jan;10(1):44-52
references.pmid: 19071061
references.citation: Dis Colon Rectum. 2004 Dec;47(12):2162-8
references.pmid: 15657669