Robotic transanal surgery for local excision of rectal neoplasia, transanal total mesorectal excision, and repair of complex fistulae: clinical experience with the first 18 cases at a single institution

Atallah, S.; Martin‐Perez, B.; Parra-Dávila, Eduardo; deBeche-Adams, Teresa; Nassif, George; Albert, Matthew; Larach, Sergio W.

doi:10.1007/s10151-015-1283-8

Cited by 48 publications

(45 citation statements)

References 49 publications

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“…6 A word of caution on the effects of the pneumorectum, as this has been described to cause a pneumodissection along soft tissues in a robotic taTME resulting in abdominal distension with need for conversion. 37 The authors hypothesized this to be the effect of prolonged operative time.…”

Section: Safety Improvementsmentioning

confidence: 99%

Future Directions

Soares

Chand

2020

Clinics in Colon and Rectal Surgery

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Transanal total mesorectal excision (taTME) is a novel technique that has evolved over the years to address the challenges of low rectal cancer surgery by applying the principles and benefits of laparoscopic surgery to more historic transanal techniques. It has been popularized through its use in rectal cancer, but the transanal approach is slowly being expanded to tackle different clinical scenarios including benign conditions such as inflammatory bowel disease and endometriosis. For all of these new indications, it is the desire to access and begin the dissection in native tissue beyond the pathology which makes this approach applicable to other diseases where anatomy can be challenging. Training pathways to safely introduce taTME in a standardized manner are being developed and implemented in a bid to ensure adequate training to all the surgeons using this technique and thus minimize complications and patient morbidity. The future directions of this promising technique include the use of image and optical technological enhancement to aid navigation, the use of pneumorectum stabilization, and perhaps the use of fluorescence as a safety improvement. Developments have come also from the field of robotics. After a demonstration of feasibility in cadaver models, a growing experience has been gathered in the robotic approach to taTME, covered in the last part of this chapter.

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Section: Safety Improvementsmentioning

confidence: 99%

Future Directions

Soares

Chand

2020

Clinics in Colon and Rectal Surgery

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“…The same authors that introduced TAMIS went on to describe the use of a robotic platform for TAMIS in a cadaveric model in 2011, 20 and then extended that robotic TAMIS platform to live patients in 2012. 21 Since then, it has been described in humans using both the GelPOINT Path platform (Applied Medical, Inc.) 22 and a glove port (►Fig. 2).…”

Section: Robotic Transanal Minimally Invasive Surgerymentioning

confidence: 99%

Transanal Approach to Rectal Polyps and Cancer

Rai

Mishra

2016

Clinics in Colon and Rectal Surgery

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A transanal approach to rectal polyp and cancer excision is often an appropriate alternative to conventional rectal resection, and has a lower associated morbidity. There has been a steady evolution in the techniques of transanal surgery over the past 30 years. It started with traditional transanal excision and was revolutionized by introduction of transanal endoscopic microsurgery in early 1980s. Introduction of transanal minimally invasive surgery made it more accessible to surgeons around the world. Now robotic platforms are being tried in certain institutions. Concerns have been raised about recurrence rates of cancers with transanal approach and success of subsequent salvage operations.

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“…Robotic‐TAMIS, first described by Attalah et al and Hompes et al has been the natural progression of laparoscopic‐TAMIS and has been shown to be successful in performing oncologic resection of low and middle rectal tumors . While the current guidelines for LE limit TAE of early rectal neoplasia to within 8 cm of the anal verge, this analysis reports the TAE of 10 rectal lesions of mixed pathology with negative margins using robotic assisted micro surgery with an average distance of 11.1 cm from the anal verge…”

Section: Introductionmentioning

confidence: 98%