Feasibility of hybrid robotic rectal surgery.

Abstract

Purpose: To investigate the feasibility of combined robotic rectal surgery and transanal total mesorectal excision (hybrid robotic surgery).

Methods: Among 143 robotic rectal surgeries performed from 2017 to 2022, 85 were hybrid robotic surgeries and were analyzed in this study. The cohort comprised 59 males and 26 females with a mean age of 65.8 years old and a mean body mass index of 22.6 kg/m². The cStage was I in 20 cases, II in 21, III in 36, IV in 4, and other in 4. The operation types were low anterior resection in 21 cases, intersphincteric resection in 27, abdominoperineal resection in 32, total pelvic exenteration in 2, and other in 3. Twelve patients (14.1%) received neoadjuvant chemotherapy or chemoradiotherapy, and 39 (45.9%) underwent lateral lymph node dissection.

Results: The mean operation time for total mesorectal excision was 302.7 min, and the median blood loss was 71.5 ml. No cases required conversion to laparotomy. The median length of postoperative hospital stay was 15.9 days. Complications of Clavien-Dindo grade ≥ 3 occurred in 3 cases (4.2%). Urinary dysfunction occurred in 6 cases (8.3%). Three (4.2%) patients were diagnosed with positive circumferential resection margins.

Conclusion: Hybrid robotic surgery is safe and oncologically feasible.