Complex robotic colorectal surgery can be performed early in the experience, with reduced operative time. Overall complications are reduced after 15 robotic cases. This study shows that improvement in robotic surgery operating time and surgical outcomes occur along with application of the technology to more difficult cases, not as a function of choosing less complex cases.
Ambulatory surgery is appropriate for most anorectal pathology. Ambulatory anorectal surgery can be performed at reduced cost compared with inpatient procedures with excellent safety, improved efficiency, and high levels of patient satisfaction. Several perioperative strategies are employed to control pain and avoid urinary retention, including the use of a multimodal pain regimen and restriction of intravenous fluids. Ambulatory anorectal surgery often utilizes standardized order sets and discharge instructions.
Purpose
In recent years, natural orifice specimen extraction surgery (NOSES) has gained widespread attention as an alternative approach. Although the safety and feasibility of NOSES have been well documented, many questions remain open for discussion. The aim of this guideline is to provide more evidence for the promotion of NOSES.
Methods
This guideline has been prepared by the CACA Committee of Colorectal Cancer Society and the International NOSES Alliance, based on the latest evidence.
Results
The guideline on NOSES for colorectal cancer include the definition, classification, technology requirement, indications, technical difficulties and clinical research.
Conclusion
The guideline provides a full introduction of the theoretical and technical aspects of NOSES for colorectal cancer which will beneficial to development of NOSES.
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