Articulating forceps in laparoscopic total mesorectal excision: A video comparison with robotic surgery

Abstract

IntroductionTotal mesorectal excision (TME) is an established standard procedure for rectal surgery; however, it is technically challenging because of the deep and narrow pelvis. Minimally invasive surgeries have gained prominence for TME with favorable outcomes but come with limitations. Laparoscopic surgery often has dexterity restrictions because of the use of straight forceps, whereas robotic surgery is impeded by high costs and extended operative times. Articulating forceps aim to bridge the gap between these methods by offering enhanced dexterity at a lower cost.Patients and Surgical TechniqueThis video study involves two female patients diagnosed with lower rectal cancer. One patient underwent laparoscopic intersphincteric resection (Lap‐ISR) using the ArtiSential articulating forceps (LIVSMED Inc.), and the other underwent robot‐assisted low anterior resection (Rob‐LAR) using the da Vinci Xi System. Both operations involved similar mesorectal dissection steps, except for the anastomosis. The standard port placement was used, and dissection was performed circumferentially down to the perianal region.DiscussionThe ArtiSential demonstrated effectiveness comparable with the da Vinci Xi system in TME surgery, with the potential advantage of improved cost‐effectiveness.