title: Combined transanal total mesorectal excision (taTME) with laparoscopic instruments and abdominal robotic surgery in rectal cancer.
abstract: Laparoscopic surgery for rectal cancer can be technically challenging. We describe a hybrid technique combining abdominal robotic dissection and transanal total mesorectal excision. This procedure was performed in a 50-year-old man with rectal adenocarcinoma at 5 cm from the dentate lane. Preoperative staging was T2N0M0. Surgery went well without complications, and estimated blood loss was less than 50 mL. Robotic surgical time was 90 min, and total operative time was 160 min. The patient was discharged on postoperative day 3. Pathology analysis revealed an intact mesorectum (TME grade 3) and a T2N0 tumor with negative margins. Hybrid surgery with pelvic robotic dissection and transanal total mesorectal excision was feasible, quick and safe in this patient and may be a method that can be developed further.
authors.affiliation: Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Spain. rbravo@clinic.ub.es.
authors.forename: R
authors.initials: R
authors.lastname: Bravo
authors.affiliation: Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Spain.|Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada.
authors.forename: J-S
authors.initials: JS
authors.lastname: Trépanier
authors.affiliation: Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Spain.|Clínica Somer, Rionegro, Antioquia, Colombia.
authors.forename: M C
authors.initials: MC
authors.lastname: Arroyave
authors.affiliation: Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Fernández-Hevia
authors.affiliation: Irvine Medical Center, University of California, Orange, CA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Pigazzi
authors.affiliation: Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
authors.forename: A M
authors.initials: AM
authors.lastname: Lacy
mesh_terms: D000005:Abdomen / Q000601:surgery; D000230:Adenocarcinoma / Q000601:surgery*; D003131:Combined Modality Therapy; D006801:Humans; D020706:Laparoscopes; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D000067368:Transanal Endoscopic Surgery / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome
keywords: Laparoscopy; Rectal cancer; Robotic surgery; Transanal TME; Transanal total mesorectal excision