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Robotic-Assisted Laparoscopic Surgery for Rectal Cancer

  • Tomohiro Yamaguchi
  • Yusuke KinugasaEmail author
Chapter

Abstract

Conventional laparoscopic surgery (CLS) for rectal cancer involves manipulation in the narrow and deep pelvic space and is thus technically demanding. Therefore, robotic-assisted laparoscopic surgery (RALS) is a promising advanced technology that is expected to overcome the inherent limitations of CLS for rectal cancer. RALS equipment has several notable advantages, including free-moving multi-joint forceps, a motion scaling function, high-quality three-dimensional imaging, operator-mediated stable camera work, and greatly improved ergonomics. In this chapter, we reviewed previous articles regarding RALS, in which this technique was associated with shorter learning curves, better functional outcomes, and similar or better oncological outcomes relative to CLS. Furthermore, many reports described a lower conversion rate of RALS compared to that of CLS. However, a randomized clinical trial comparing RALS versus CLS demonstrated that former did not significantly reduce the risk of conversion to open surgery. The high cost associated with RALS is also an important issue. As high-level evidence for RLAS remains to be well established, surgeons should expand their indications safely and cautiously. Further evaluations of the short- and long-term outcomes of RALS, including the patient’s quality of life and cost-effectiveness, are needed to support the use of this technique.

Keywords

Conventional laparoscopic surgery da Vinci surgical system Lateral lymph node dissection Open surgery Rectal cancer Robotic-assisted laparoscopic surgery 

Notes

Acknowledgement

Disclosure: Tomohiro Yamaguchi and Yusuke Kinugasa have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Gastroenterological SurgeryCancer Institute Hospital of the Japanese Foundation for Cancer ResearchTokyoJapan
  2. 2.Division of Colon and Rectal SurgeryShizuoka Cancer Center HospitalShizuokaJapan
  3. 3.Department of Gastrointestinal SurgeryTokyo Medical and Dental UniversityTokyoJapan

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