Totally Robotic Complete Mesocolic Excision and Central Vascular Excision for Right-Sided Colon Cancer

Sung Uk Bae, Chang Woo Kim, Min Soo Cho, Hyun A Jang, Se Jin Baek, Hyuk Hur, Seung Hyuk Baik, Nam Kyu Kim, Byung Soh Min. Yonsei University College of Medicine.

Background: Although robotic surgery aims to overcome the limitations of conventional laparoscopic surgery, the role of robotic surgery for colon cancer is still largely undefined. A concept of complete mesocolic excision (CME) and central vascular ligation (CVL) for colonic cancer has been recently introduced. The aim of this study is to describe our initial experience and assess the clinicopathologic outcomes of robotic CME and CVL for right-sided colon cancer.

Methods: The study group included 28 patients who underwent a totally robotic CME and CVL for right-sided colon cancer between February 2008 and May 2013.

Results: All 28 procedures were technically successful without the need for conversion to laparoscopic or open surgery. The mean operation time, console time, docking time were 315±93, 145±55, and 6.8±4.0 min, respectively. Mean estimated blood loss was 128±133 ml. The mean time to soft diet was 4±1.5 days and length of stay was 7.2±1.6 days. The proximal and distal resection margin was 14.3±10.9 and 16.2±8.9, respectively. The median total number of lymph nodes harvested was 29.6±14.2. According to the Clavien–Dindo classification, the numbers of complications for grade1, 2, 3a, 3b, and 4 were 2, 2, 0, 0, and 0. There was no mortality within 30 days.

Conclusions: Robotic CME and CVL for right-sided colon cancer could be safely performed with a favorable clinicopathologic outcomes. Robotic technique can be a suitable procedure to maximize the dissection of the lymph nodes around central vessels with the stable camera platform and articulated instruments without tremor.

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