Robotic Surgery for Rectal Cancer in Our Center -First 50 resection-

Chu Matsuda, Katsuki Danno, Susumu Miyazaki, Kazumasa Fujitani, Masaru Kubota, Masaaki Motoori, Rie Nakatsuka, Masashige Nishimura, Akihiro Kitagawa, Kazuhiro Iwase. Osaka General Medical Center

Introduction: Robotic surgery remains a novel technique in the field of colorectal surgery in Japan. Several small series have examined its safety and feasibility for colorectal surgery. Our aim was to analyze our entire experience and short-term outcomes with robotic surgery for rectal cancer since its introduction at our institution. We assert that this approach is feasible and safe for the patients with rectal cancer.

Material and Methods: This is a retrospective analysis of prospectively gathered data for all patients who underwent robotic surgery for rectal cancer with the use of single docking technique  of Da Vinci S or Si system between November 2012 and ber 2015. Clinical, operative and pathologic factors were reviewed and analyzed.

Results: Thirty patients underwent robotic surgery for rectal cancer during the study period. The locations of tumor were 20 upper rectum, 30 lower rectum. The procedure were as follow, high anterior resection in 6, low anterior resection in 36, ISR in 3, APR in 5 patients. The procedures were performed successfully in all cases. Mean age was 68 years, and 64% of the patients were men, and the mean body mass index was 22.4( range, 18.5-29.4) kg/m2. Median operative duration was 286(190-581)minutes. Median console duration was 147(78-441)minutes. Median blood loss was 10(0-270)ml. Median postoperative stay was 9 (6-16) days. Mean harvest lymph node number was 17.0 (5-37).Surgical margins were negative in all cases. There was no conversion and anastomotic leakage occurred in two patients. Morbidity was 18%. There was no mortality postoperatively in this series.

Conclusion: In early series of the selected patients, this technique appears to be fesible and safe when performed by surgeons skilled in laparoscopic colorectal surgery. These findings support the use of a robotic approach for patients requiring rectal surgery.