title: Robotic-assisted transabdominal intersphincteric resection: a technique involving a completely abdominal approach and coloanal anastomosis.
abstract: BACKGROUND
  As the use of a surgical robot allows for improved dexterity and visual field, we successfully conducted transabdominal intersphincteric resection (ISR) and perineal coloanal anastomosis for a very low lying rectal cancer. The aim of this study was to evaluate the technical feasibility of this procedure.
  
  
  METHODS
  Eight patients underwent robotic-assisted transabdominal ISR with coloanal anastomosis for low rectal cancers. The surgical procedures included 5 steps: colonic mobilization with ligation of inferior mesenteric vessels, total mesorectal excision, intersphincteric dissection with rectal transection, specimen retrieval, and coloanal anastomosis.
  
  
  RESULTS
  The median operation time was 210 minutes, and the median estimated blood loss was 40.0 mL. The hypogastric nerve and pelvic nerve plexus was preserved in all patients. No intraoperative-related or robotic system-related morbidities were observed. In all patients, R0 resection was achieved, and the quality of the total mesorectal excision was optimal.
  
  
  CONCLUSIONS
  Robotic transabdominal ISR is a safe operation with an expectation of future advances in pathologic quality and functional preservation. Additional work in a larger series of patients is necessary to refine this technique and to establish its efficacy.
authors: Department of Surgery, School of Medicine, Colorectal Cancer Center, Kyungpook National University Medical Center, Kyungpook National University, Daegu, Korea.
authors: Soo Yeun
authors: SY
authors: Park
authors: Gyu-Seog
authors: GS
authors: Choi
authors: Jun Seok
authors: JS
authors: Park
authors: Hye Jin
authors: HJ
authors: Kim
authors: Whon-Ho
authors: WH
authors: Choi
authors: Jong Pil
authors: JP
authors: Ryuk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D016063:Blood Loss, Surgical; D003106:Colon / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000379:methods; D012004:Rectal Neoplasms / Q000601:surgery*; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome