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Robotic‐assisted laparoscopic abdominoperineal resection for anal cancer: feasibility and technical considerations
Author(s) -
Patel Chirag B.,
RamosValadez Diego I.,
Haas Eric M.
Publication year - 2010
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.348
Subject(s) - abdominoperineal resection , medicine , surgery , anal cancer , dissection (medical) , pelvis , colorectal cancer , robotic surgery , laparoscopic surgery , laparoscopy , cancer
Abstract Background Robotic‐assisted laparoscopic surgery is an emerging technology that may prove advantageous for complex colorectal procedures involving the irradiated pelvis, such as abdominoperineal resection for recurrent anal cancer. The authors' initial experience is presented, with assessment of feasibility, safety, and oncologic principles. Methods Over a 6 month period, five abdominoperineal resections were performed using the da Vinci® robot for recurrent anal cancer in patients initially treated with definitive chemoradiation therapy. Demographics, intraoperative parameters, pathology, and outcomes were assessed. Results Five patients underwent surgery with a mean age of 58.8 years and body mass index of 24.9 kg m −2 . The interval between chemoradiation and salvage APR was 14.2 ± 10.0 months. Operative time was 204 ± 39.1 min with robotic docking time 12.2 ± 2.8 min and console time 93.0 ± 24.9 min. The mean estimated blood loss was 150 cc and there were no intraoperative complications. The mean hospital length of stay was 5.4 days. Pathology analysis revealed that all surgical margins were adequate. There was one postoperative complication consisting of a seroma. Conclusion Robotic‐assisted laparoscopic surgery for anal cancer was found to be a safe and feasible procedure. It facilitated enhanced visualization and dissection through deep irradiated pelvic structures. Copyright © 2010 John Wiley & Sons, Ltd.