Surgical Endoscopy

, Volume 27, Issue 4, pp 1407–1409 | Cite as

Robotic transanal access surgery

  • Ovunc BardakciogluEmail author


Transanal use of laparoscopic instrumentation has been described in several case reports as an alternative to transanal endoscopic microsurgery (TEM). Both of these techniques have significant technical limitations due to anatomical constrictions. Robotic technology with articulating instruments has been effectively used in many areas with anatomic limitations similar to the intraluminal use within the rectum. We present the technique of a full-thickness transanal resection of a rectal polyp with endorectal suturing using a robotic platform. Larger case series and trials are needed to compare outcome and cost with TEM. Alternative robotic platforms and instrumentation may be further developed for different and more advanced indications of transanal access surgery.


Robotic surgery Transanal endoscopic microsurgery Local excision Rectal cancer 




The author is a proctor with Intuitive Surgical.

Supplementary material

Supplementary material 1 (M4V 183822 kb)


  1. 1.
    Buess R, Theiss G, Guenther M et al (1985) Transanal endoscopic microsurgery. Leber, Magen, Darm 15:271–279PubMedGoogle Scholar
  2. 2.
    Transanal endoscopic microsurgery: a systematic review (2012) Centre for Reviews and Dissemination. EBM reviews—database of abstracts of reviews of effects, database of abstracts of reviews of effects. Issue 1Google Scholar
  3. 3.
    Moore J, Cataldo P, Osler T (2008) Transanal endoscopic surgery is more effective than traditional transanal excision of rectal masses. Dis Colon Rectum 51:1026–1031PubMedCrossRefGoogle Scholar
  4. 4.
    Ribeiro da Rocha JJ, Feres O (2008) A new proctoscopy for transanal endoscopic operations. Tech Coloproctol 12:241–246PubMedCrossRefGoogle Scholar
  5. 5.
    Swanstrom LL, Smiley P, Zelko J et al (1997) Video endoscopic transanal-rectal tumor excision. Am J Surg 173(5):383–385PubMedCrossRefGoogle Scholar
  6. 6.
    Khoo REH (2010) Transanal excision of a rectal adenoma using single-access laparoscopic port. Dis Colon Rectum 53:1078–1079PubMedCrossRefGoogle Scholar
  7. 7.
    Atallah SB, Albert MR, Larach S (2010) Transanal minimally invasive surgery: a giant leap forward. Surg Endosc 24:2200–2205PubMedCrossRefGoogle Scholar
  8. 8.
    Ragupathi M, Haas EM (2011) Transanal endoscopic video-assisted excision: application of single-port access. JSLS 15:53–58PubMedCrossRefGoogle Scholar
  9. 9.
    Dardamanis D, Theodorou D, Theodoropulos G et al (2011) Transanal polypectomy using single incision laparoscopic instruments. World J Gastrointest Surg 3(4):56–58PubMedCrossRefGoogle Scholar
  10. 10.
    Barendse RM, Doornebosch PG, Bemelman WA, et al. (2012) Transanal employment of single access ports is feasible for rectal surgery. Ann Surg. doi: 10.1097/SLA.0b013e3182523b31
  11. 11.
    Lorenz C, Nimmesgern T, Back M et al (2010) Transanal single port microsurgery (TSPM) as a modified technique of transanal endoscopic microsurgery. Surg Innov 17(2):160–163PubMedCrossRefGoogle Scholar
  12. 12.
    Van den Boezem PB, Kruyt PM, Stommel MW et al (2011) Transanal single-port surgery for the resection of large polyps. Dig Surg 28(5–6):412–416 Epub 2011 Dec 20PubMedCrossRefGoogle Scholar
  13. 13.
    Smith RA, Anaya DA, Albo D et al (2012) A stepwise approach to transanal endoscopic microsurgery for rectal cancer using a single-incision laparoscopic port. Ann Surg Oncol 19(9):2859PubMedCrossRefGoogle Scholar
  14. 14.
    Demirbas S, Cetiner S, Ozer TM et al (2012) The use of single port surgery for polyps located in the rectum. Turk J Gastroenterol 23(1):66–71PubMedGoogle Scholar
  15. 15.
    Atalla SB, Albert MR, deBeche-Adams TH et al (2011) Robotic transanal minimally invasive surgery in a cadaveric model. Tech Coloproctol 15:461–464CrossRefGoogle Scholar
  16. 16.
    Wolthuis AM, Cini C, Penninckx F et al (2012) Transanal single port access to facilitate distal rectal mobilization in laparoscopic rectal sleeve resection with hand-sewn coloanal anastomosis. Tech Coloproctol 16:161–165PubMedCrossRefGoogle Scholar
  17. 17.
    Denk PM, Swanstrom LL, Whiteford MH (2008) Transanal endoscopic microsurgical platform for natural orifice surgery. Gastrointest Endosc 68:954–959PubMedCrossRefGoogle Scholar
  18. 18.
    Marks JH (2011) TEM as a platform for NOTES. J Gastrointest Surg 15:1313–1315PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Colon & Rectal SurgerySaint Louis UniversitySt. LouisUSA

Personalised recommendations