title: Clinical and oncologic outcomes of totally robotic total mesorectal excision for rectal cancer: initial results in a center for minimally invasive surgery.
abstract: OBJECTIVE
  A robotic system was mainly designed to allow precise dissection in deep and narrow spaces. We report the clinical and oncologic outcomes of totally robotic total mesorectal excision for rectal cancer.
  
  
  METHODS
  Between July 2009 and January 2012, 60 consecutive patients undergoing robotic surgery for rectal cancer at the Eulji University Hospital were included.
  
  
  RESULTS
  The mean total operation time, docking time, and surgeon console time were 466.8 ± 115.6, 7.5 ± 6.7, and 261 ± 87.5 min, respectively. Oral intake of diet was started at 3.3 ± 0.9 days and the mean hospital stay was 8.6 ± 2.4 days. All 60 procedures were technically successful without the need for conversion to open or laparoscopic surgery. Complications included anastomotic leakage, anastomotic stricture, postoperative bleeding, ileus, and perineal wound infection in 3 (5 %), 1 (1.7 %), 2 (3.3 %), 2 (3.3 %), and 1 (1.7 %) patient, respectively. The mean distal resection margin and total number of lymph nodes harvested was 3.1 ± 1.7 cm and 20.1 ± 11.5, respectively. During the mean follow-up period of 48.5 months (range, 7-75), the 4-year overall and disease-free survival rates were 87.7 and 72.8 %, respectively.
  
  
  CONCLUSIONS
  A totally robotic approach for rectal cancer operations was a time-consuming procedure, although we already had a lot experience in laparoscopic colorectal surgery. However, the dexterity of the robotic surgery could enable the surgeon to expand the choice of surgical methods according to the condition of the rectal cancer without the need for conversion.
authors.affiliation: Department of Surgery, Eulji University Hospital, School of Medicine, Eulji University, 95 Dunsanseo-ro, Seo-gu, Daejeon, 302-799, South Korea. kimcn7@gmail.com.
authors.forename: Chang-Nam
authors.initials: CN
authors.lastname: Kim
authors.affiliation: Department of Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, South Korea.
authors.forename: Sung Uk
authors.initials: SU
authors.lastname: Bae
authors.affiliation: Department of Surgery, Eulji University Hospital, School of Medicine, Eulji University, 95 Dunsanseo-ro, Seo-gu, Daejeon, 302-799, South Korea.
authors.forename: Seul-Gi
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Department of Surgery, Eulji University Hospital, School of Medicine, Eulji University, 95 Dunsanseo-ro, Seo-gu, Daejeon, 302-799, South Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Yang
authors.affiliation: Department of Surgery, Eulji University Hospital, School of Medicine, Eulji University, 95 Dunsanseo-ro, Seo-gu, Daejeon, 302-799, South Korea.
authors.forename: In Gun
authors.initials: IG
authors.lastname: Hyun
authors.affiliation: Department of Surgery, Eulji University Hospital, School of Medicine, Eulji University, 95 Dunsanseo-ro, Seo-gu, Daejeon, 302-799, South Korea.
authors.forename: Je Ho
authors.initials: JH
authors.lastname: Jang
authors.affiliation: Department of Surgery, Eulji University Hospital, School of Medicine, Eulji University, 95 Dunsanseo-ro, Seo-gu, Daejeon, 302-799, South Korea.
authors.forename: Byung Sun
authors.initials: BS
authors.lastname: Cho
authors.affiliation: Department of Surgery, Eulji University Hospital, School of Medicine, Eulji University, 95 Dunsanseo-ro, Seo-gu, Daejeon, 302-799, South Korea.
authors.forename: Joo Seung
authors.initials: JS
authors.lastname: Park
mesh_terms: D000368:Aged; D003710:Demography; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D019990:Perioperative Care; D049268:Positron-Emission Tomography; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012371:Robotics; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Laparoscopy; Outcome assessment; Rectal neoplasms; Robotic surgical procedures