Ada E Graham, MD, Natalie Pudalov, Vincent Obias, MD. George Washington University Hospital
Introduction: Treatment for early rectal cancer has evolved from the total mesorectal excision with data to support local excision. The nonlinear anatomy of the rectum and distal colon make surgical access and visualization of these regions challenging given the linear nature of most instrumentation used. We present our experience and results from the first 11 human subjects who have undergone surgery for early rectal neoplasia with a new robotics surgical system: the Medrobotics FlexTM Colorectal Drive, which uses a transanal approach with fully articulating instruments to address pathology in the distal colon and rectum. We aimed to assess the safety and feasibility of this new platform in this retrospective review.
Methods and Procedures: Preoperatively, patients were selected based on favorable polyp and lesion characteristics to demonstrate the feasibility and safety of this transanal approach. In this retrospective review of a single surgeon’s database, 11 patients were deemed appropriate candidates. Patient age, sex, operative time, estimated blood loss, post-operative complications and margins were recorded.
Results: Polyps were removed at distances 2 to 17cm from the anal verge, and as large as 8cm, without complications. One case involving a GIST tumor had a positive deep margin, which was resected with a deeper biopsy to achieve negative margins. A case concerning a single tumor at 12cm was unable to be resected and required operative conversion, thought to be a combination of surgeon learning curve and sub-optimal patient positioning. Average operative time was 110 ± 39.9 minutes, average blood loss 9.1± 13.6 cc. All patients were discharged on the day of surgery without post-operative complications.
Conclusions: This is the first data on a new transanal, endoluminal robotic platform that can maintain pneumorectum, the Medrobotics FlexTM Colorectal Drive, which was demonstrated to be safe and clinically feasible for the removal of early anorectal neoplasia.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93934
Program Number: P417
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster