Premium
Robotic interface for transabdominal division of the levators and pelvic floor reconstruction in abdominoperineal resection: a case report and technical description
Author(s) -
Bae Sung U.,
Saklani Avanish P.,
Hur Hyuk,
Min Byung S.,
Baik Seung H.,
Kim Nam K.
Publication year - 2015
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.1624
Subject(s) - abdominoperineal resection , computer science , pelvic floor , division (mathematics) , resection , interface (matter) , surgery , medicine , operating system , cancer , colorectal cancer , arithmetic , mathematics , bubble , maximum bubble pressure method
Background Extralevator abdominoperineal resection (APR) in a prone jackknife position was developed to avoid a positive circumferential resection margin, and its application led to lower rates of local recurrence. The paper describes a technique of robotic extralevator APR with transabdominal levator division followed by pelvic floor reconstruction with bilayered composite mesh. Methods A 42‐year‐old man with low rectal cancer required APR that was performed in a lithotomy position with transabdominal division of the levators. After the perineal phase, the robot was redocked and a bilayered composite mesh was sutured to the pelvic inlet using robotic needle drivers. Results The specimen had a cylindrical shape, and there was no surgical waist or perforation. Histology revealed a ypT2N0 tumor without circumferential margin involvement. Conclusions The robotic interface can aid in APR by accurately transecting the levators from the top. Additionally, it allows suturing of mesh around the pelvic inlet to prevent perineal hernias. Copyright © 2014 John Wiley & Sons, Ltd.