Robot-assisted extralevatory abdominoperineal extirpation of the rectum with transabdominal levator transеction in a patient in lithotomy position

Abstract

Objective: to evaluate safety and efficacy of robot-assisted extralevatory abdominoperineal extirpation of the rectum with transabdominal levator transеction in a patient in lithotomy position.Materials and methods. Within this study, we analyzed clinical observations of several patients who underwent robot-assisted extralevatory abdominoperineal extirpation of the rectum with transabdominal levator transеction at lithotomy position, conducted in the Saint Petersburg City Hospital No 40 during 2015–2016. We assessed the main intraoperative characteristics, postoperative complications, and pathological features of removed organs.Results and discussion. We analyzed the data on 5 patients. All of them underwent R0 resection. The number of resected lymph nodes varied from 15 to 21. Maximum blood loss was 100 ml. The duration of surgery was between 150–210 min. One patient had a postoperative complication – intrapelvic bleeding in the early postoperative period.Conclusion. The use of the described surgical method allowed to perform R0 resections in all patients without losing the advantages of minimally invasive surgery, including small blood loss, early recovery of peristalsis, and rapid rehabilitation of the patients.

Keywords

• rectal cancer
• robot-assisted surgery
• transabdominal levator transection