Skip to main content
  • 537 Accesses

Abstract

In this chapter, we aim to describe the robotic total mesocolic excision (TMCE) technique for colon cancer. We will discuss the basics of TMCE and specifically the robotic approach. Robotic technology offers better dexterity, increased triangulation, and ergonomic superiority. The disadvantages like increased cost and operative time may be counterbalanced by achievement of better specimen quality and improved oncologic outcomes, which needs further investigation. We will describe the procedural steps in each approach in detail with special emphasis on the key points in every step.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery – the clue to pelvic recurrence? Br J Surg. 1982;69:613–6.

    Article  CAS  Google Scholar 

  2. Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation – technical notes and outcome. Colorectal Dis. 2009;11:354–64; discussion 364–355.

    Article  CAS  Google Scholar 

  3. West NP, Kobayashi H, Takahashi K, Perrakis A, Weber K, Hohenberger W, Sugihara K, Quirke P. Understanding optimal colonic cancer surgery: comparison of Japanese D3 resection and European complete mesocolic excision with central vascular ligation. J Clin Oncol Off J Am Soc Clin Oncol. 2012;30:1763–9.

    Article  Google Scholar 

  4. West NP, Hohenberger W, Weber K, Perrakis A, Finan PJ, Quirke P. Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol Off J Am Soc Clin Oncol. 2010;28:272–8.

    Article  Google Scholar 

  5. Bertelsen CA, Neuenschwander AU, Jansen JE, Wilhelmsen M, Kirkegaard-Klitbo A, Tenma JR, Bols B, Ingeholm P, Rasmussen LA, Jepsen LV, Iversen ER, Kristensen B, Gogenur I. Disease-free survival after complete mesocolic excision compared with conventional colon cancer surgery: a retrospective, population-based study. Lancet Oncol. 2015;16:161–8.

    Article  Google Scholar 

  6. West NP, Morris EJ, Rotimi O, Cairns A, Finan PJ, Quirke P. Pathology grading of colon cancer surgical resection and its association with survival: a retrospective observational study. Lancet Oncol. 2008;9:857–65.

    Article  Google Scholar 

  7. Turnbull RB Jr, Kyle K, Watson FR, Spratt J. Cancer of the colon: the influence of the no-touch isolation technic on survival rates. Ann Surg. 1967;166:420–7.

    Article  Google Scholar 

  8. Willaert W, Mareel M, Van De Putte D, Van Nieuwenhove Y, Pattyn P, Ceelen W. Lymphatic spread, nodal count and the extent of lymphadenectomy in cancer of the colon. Cancer Treat Rev. 2014;40:405–13.

    Article  Google Scholar 

  9. Johnson PM, Porter GA, Ricciardi R, Baxter NN. Increasing negative lymph node count is independently associated with improved long-term survival in stage IIIB and IIIC colon cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2006;24:3570–5.

    Article  Google Scholar 

  10. Schumacher P, Dineen S, Barnett C Jr, Fleming J, Anthony T. The metastatic lymph node ratio predicts survival in colon cancer. Am J Surg. 2007;194:827–31; discussion 831–822.

    Article  Google Scholar 

  11. Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, Visa J. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet (London, England). 2002;359:2224–9.

    Article  Google Scholar 

  12. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy AM. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6:477–84.

    Article  Google Scholar 

  13. Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, Quirke P, West N, Rautio T, Thomassen N, Tilney H, Gudgeon M, Bianchi PP, Edlin R, Hulme C, Brown J. Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA. 2017;318:1569–80.

    Article  Google Scholar 

  14. Carmichael JC, Stamos MJ. Right hemicolectomy and ileocecectomy: laparoscopic approach. In: Bardakcioglu O, editor. Advanced techniques in minimally invasive and robotic colorectal surgery. Boston: Springer; 2015.

    Google Scholar 

  15. Benlice C, Stocchi L, Costedio MM, Gorgun E, Kessler H. Impact of the specific extraction-site location on the risk of incisional hernia after laparoscopic colorectal resection. Dis Colon Rectum. 2016;59:743–50.

    Article  Google Scholar 

  16. Matsuda T, Iwasaki T, Mitsutsuji M, Hirata K, Maekawa Y, Tsugawa D, Sugita Y, Sumi Y, Shimada E, Kakeji Y. Cranially approached radical lymph node dissection around the middle colic vessels in laparoscopic colon cancer surgery. Langenbeck’s Arch Surg. 2015;400:113–7.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Electronic Supplementary Material

Dissection and clipping of ileocolic artery and vein (MP4 88361 kb)

Dissection and clipping of Henle’s trunk (MP4 131428 kb)

Gastrocolic vein dissection (MP4 150038 kb)

Preserving peritoneal window and surgical trunk (MP4 134736 kb)

Transection of bowel loops (MP4 91949 kb)

Quality of the specimen (MP4 89409 kb)

Intracorporeal anastomosis (MP4 90776 kb)

Ligation of the IMV (MP4 66559 kb)

Splenic flexure mobilization (MP4 150795 kb)

Specimen extraction (MP4 82638 kb)

Colocolic anastomosis (MP4 150235 kb)

Ligation of the left colic vessels (MP4 145043 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Atasoy, D., Baca, B., Hamzaoglu, I., Karahasanoglu, T. (2019). Robotic Total Mesocolic Excision. In: Bardakcioglu, O. (eds) Advanced Techniques in Minimally Invasive and Robotic Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-15273-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-15273-4_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-15272-7

  • Online ISBN: 978-3-030-15273-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics