Robotic transanal total mesorectal excision for rectal cancer: experience with a first case.

Abstract

A transanal approach for total mesorectal excision (TME) using a single incision port is feasible. The disadvantages are technical difficulties associated with limited manoeuvrability. We present our first experience with robotic-assisted transanal total mesorectal excision. A 48 year-old woman with a tumour 8 cm from the anal verge was successfully operated using a transanal approach. A complete mesorectal excision was performed through a single incision port, using two robot arms. TME was performed successfully and the patient recovered quickly without any complications. The histological report showed a complete mesorectal excision with free distal and circumferential margins. A sigmoidoscopy showed an intact anastomosis and the patient was planned for reversal of her ileostomy. Transanal total mesorectal excision using the robot is feasible. Robotics may help to overcome technical difficulties associated with the single incision port.