Despite the advantages of laparoscopic surgery, this technique has its own limitations, with a two-dimensional view, limitations in the range of movements, and fulcrum effects of various bony aspects of the pelvis, resulting in problems in access and exposure, especially in the pelvic depths of patients with large tumors and obesity. The robotic approach seems to be a valid alternative to combat some of the issues encountered with laparoscopy. Three-dimensional views, endo-wristed instrumentation, and a stable camera platform make it a very attractive option for the surgeon. This may translate into improved tissue dissection, accurate cancer clearance, precision surgery with minimal collateral damage, and excellent functional outcomes for patients.
A robotic approach to the pelvis for rectal cancer is feasible and safe, and the initial results are very encouraging. Large series from high volume centres might provide the evidence for its efficacy and cost effectiveness. The preservation of sexual, urological and bowel function, and decreased fatigue and stress for the surgeon, will be major stand-out points encouraging surgeons to embrace this technology for management of rectal cancer.
In this lecture, Dr. Jin-Cheon Kim focuses on the robotic treatment of low rectal cancer. To improve surgeon training and intraoperative performance, this lecture finishes with an elegant transabdominal inter-sphincteric resection video.