The use of Robotic Surgery for Colorectal surgery
Robotic surgery for the prostate is practised widely in the USA and is now becoming more widespread in the UK. Robotic surgery for colorectal disease has become more common in South Korea, USA and Singapore as well as in several European centres in Germany, Italy, France and Spain. There are very few centres using the robot for colorectal surgery in the UK.
Nearly 1.5 million procedures have been performed world wide using the da Vinci system.
The advantages of using a robotic approach may become particularly relevant in low rectal surgery, such as anterior resection or abdominoperineal excision of the rectum. Here, as the surgeon operates lower in the pelvis, the need for better and stable optical systems retraction exposure and articulating instruments becomes evident.
Robotic surgery has been used to treat rectal prolapse and to perform posterior rectopexy and ventral mesh rectopexy. The dissection is enhanced and the articulating instruments provide the ability to precision suturing within the pelvis.
Robotic proctectomy as part of an ileal pouch procedure is a technically challenging procedure laparoscopically. The use of a robot can facilitate the rectal resection as the platform provides a better and stable optical system, better retraction and exposure which allows easier low dissection and rectal cross stapling.
Again the benefits may be more evident in the narrow male pelvis or in the obese patient.
M.J.Waldron. West Midlands. July 2011.