title: Preclinical cadaveric study of transanal robotic proctectomy with total mesorectal excision combined with laparoscopic assistance.
abstract: BACKGROUND
  Anterior resection with total mesorectal excision (TME) is the standard method of rectal cancer resection. However, this procedure remains technically difficult. A robotic transanal approach could overcome some of these limitations. An initial laboratory experience with robotic transanal TME using a new designed port on human cadavers is reported.
  
  
  METHODS
  The feasibility of robotic transanal TME and ideal set-up were evaluated in human cadavers. For the da Vinci Si HD system transanal access and total mesorectal excision, a specifically designed port was used.
  
  
  RESULTS
  It was possible to complete a proctectomy with transanal total mesorectal excision. The port proved to be very reliable and facilitated docking of the robotic arms.
  
  
  CONCLUSIONS
  Using the robotic technology and a specifically designed port for robotic transanal access, TME was shown to be feasible and one specific preferred set-up was determined. Further clinical trials will be necessary to assess the safety and efficacy of this technique.
authors.affiliation: Department of Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gomez Ruiz
authors.affiliation: Department of Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Martin Parra
authors.affiliation: Department of Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Calleja Iglesias
authors.affiliation: Department of Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: H
authors.initials: H
authors.lastname: Stein
authors.affiliation: Department of Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Sprinkle
authors.affiliation: Department of Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Manuel Palazuelos
authors.affiliation: Department of Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Alonso Martin
authors.affiliation: Department of Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Cagigas Fernandez
authors.affiliation: Department of Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Castillo Diego
authors.affiliation: Department of Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gomez Fleitas
mesh_terms: D001003:Anal Canal / Q000033:anatomy & histology / Q000601:surgery; D002102:Cadaver; D013505:Digestive System Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods; D008297:Male; D008953:Models, Anatomic; D057605:Natural Orifice Endoscopic Surgery / Q000295:instrumentation / Q000379:methods; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000033:anatomy & histology / Q000601:surgery; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*
keywords: rectal cancer; robotic surgery; transanal