Comment on “Early results of novel robotic surgery-assisted low anterior resection for rectal cancer and transvaginal specimen extraction by using Da Vinci XI: initial clinical experience”

Abstract

Dear Editor,We are pleased to read the article entitled "Early results of novel robotic surgery-assisted low anterior resection for rectal cancer and transvaginal specimen extraction by using Da Vinci XI: initial clinical experience" by Çakır et al. 1 . In this study, the authors evaluated the early outcomes of robotic surgery-assisted anterior resection for low rectal cancer and transvaginal specimen extraction (TVSE). The authors explained the importance of TVSE for women in two aspects: it can bring good cosmetic effect and effectively reduce the complications related to additional skin incision. However, there are still some problems that need our further thinking and exploration.Both transvaginal extraction and transanal extraction belong to natural orifice specimen extraction (NOSE). In this article, TVSE was used, and the research object was limited to women. As we know, different genders have different human structures. The rectum is the last segment of the bowel, which is connected with the sigmoid colon on the upper part and the anus on the lower part. In female, the uterus and vagina are located in the front of rectum, and in male, the bladder, seminal vesicle, and prostate lie in front of the rectum. In clinical practice, many studies 2,3 used transanal specimen extraction. Comparing the two methods of NOSE, transanal specimen extraction technology is more applicable to a wide range of people (both men and women). To the best of our knowledge, the authors illustrates the importance of TVSE for women, but we suggest comparing the two methods of NOSE in terms of