Alberto Arezzo, MD. University of Torino
The video shows a case of Laterally Spreading Tumour of the rectum with preoperative benign histology, Paris Classification 0-Is G (granular type), uT0N0 EUS stage, Kudo type IV, NICE type 2. The neoplasm measured 6 x 7 cm, and extended from 6 to 12 cm from the anal verge, mainly located on the posterior wall. According to our local policy the indication was a transanal full-thickness excision. This was performed with the Medrobotics Flex® Robotic System, used here for the first time outside the United States.
The system technology utilizes an articulated multi-linked scope that can be steered along non-linear, circuitous paths in a way that is not possible with traditional, straight scopes. The maneuverability of the scope is derived from its numerous mechanical linkages with concentric mechanisms. This enables surgeons to perform minimally-invasive procedures in places that were previously difficult, or impossible, to reach. With the Flex® Robotic System, Surgeons can operate through a single access site and direct the scope to the surgical target. Once positioned, the scope can become rigid, forming a stable surgical platform from which the surgeon can pass flexible surgical instruments. The system includes on-board 3D HD visualization. The Flex® Robotic System contains two working channels to accept a number of different surgical and interventional instruments including monopolar and bipolar electrodes, scissors and graspers for tissue manipulation.
The video shows the introduction of the dedicated rectoscope, the connection of the flexible robot, and the way to operate the device performing a full-thickness excision, including suturing of the rectal defect by means of two running sutures by a V-Lock 3/0 thread. While illustrating the technique the authors will comment pros and cons of the use of the device.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 98710
Program Number: ETP719
Presentation Session: Emerging Technology Poster Session (Non CME)
Presentation Type: Poster