Abstract
[full article, abstract in English; abstract in Lithuanian]
 Until recently, robotic surgery has been associated only with da Vinci robotic system. A novel Senhance® robotic system (TransEnterix Surgical Inc., Morrisville, NC, USA) has been introduced almost 5 years ago. Published reports on experience in colorectal surgery using this robotic platform is very limited. We present a prospective analysis of first 13 robotic colorectal surgeries in Klaipėda University Hospital, Klaipėda, Lithuania. 13 patients underwent various colorectal resections: 10 for colorectal cancer and 3 for colonic polyps. 7 were men and 6 women, age range 32–77 years, on an average 56 years. Among 10 patients with colorectal cancer, 3 had stage I, 3 stage II, 3 stage III and 1 stage IV colorectal cancer. 2 patients were operated for unremovable ascending colon adenomas and 1 underwent prophylactic subtotal colectomy with ileorectal anastomisis for familial adenomatous polyposis. Complication occurred in 1 case (7.7%). This patient underwent robotic abdominoperineal resection for low rectal cancer, developed postoperative bleeding from perineal wound on day 7 and had to be taken to operative room for oversuturing the bleeding vessel. Operative time was on an average 3 hours 50 minutes, ranging from 2 hours and 55 minutes to 6 hours and 10 minutes. In-hospital stay ranged from 5 to 16 days, on an average 7 days.
 Conclusion. Our experience with different types of robotic colorectal resections allows us to state that Senhance® robotic system is feasible and safe for colorectal surgery, and wider implementation of this system in our specialty worldwide is simply a question of time.
Highlights
The possibility of performing minimally invasive colorectal surgery, including colon cancer, has been demonstrated more than a quarter of a century ago [1]
Since and already quite a while ago, we learned about the safety of laparoscopic surgery for colon cancer [2,3,4]
There have been a number of trials in favor of laparoscopic rectal cancer surgery, though two relatively recent non-inferiority trials have put certain doubt on laparoscopic rectal cancer surgery in comparison with the open approach [5,6]
Summary
The possibility of performing minimally invasive (laparoscopic) colorectal surgery, including colon cancer, has been demonstrated more than a quarter of a century ago [1]. It seems to be reasonable to expect that robotic approach which has technological privileges including improved view and articulating instruments would help to perform surgeries in narrow spaces such as pelvis in rectal cancer surgery. There was a lot expected from ROLLARR randomized clinical trial [8] to give a solid background for this new type of surgery applied for rectal cancer, to demonstrate it superiority compared to conventional laparoscopy at least in terms of risk of conversion, but neither this nor secondary rectal cancer specific endpoints of this trial did show any difference between the two groups.
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