Application of Da Vinci surgical system in the treatment of low rectal cancer / 中华消化外科杂志

ABSTRACT

The first few cases of colonic surgery using Da Vinci surgical system were reported in 2002;since then,Da Vinci surgical system has gradually been used in several centers for rectal cancer and with favorable outcomes.Laparoscopy has opened a new era in modern surgery,however,the inherent limitations of traditional laparoscopic surgery may cause certain difficulties during manipulation,especially in the demanding field of colonic laparoscopic surgery,which prolonged the learning curve.The advantages of Da Vinci surgical system include stable camera platform,three-dimensional imaging,excellent ergonomics,tremor elimination,ambidextrous capability,motion scaling,and instruments with multiple degrees of freedom.Low rectal region was regarded as the"forbidden zone"for laparoscopy,so we applied the Da Vinci surgical system in low anterior resection for rectal cancer.Because of mulyiquadrant operations in low anterior resection of rectal cancer,moving the robotic cart twice during the operation is necessary,which increased the operation time.In order to solve the problem,many surgeons use conventional laparoscopy for vessel ligation and flexure mobilization,and adopt the Da Vinci surgical system only in the lower quadrant of the abdomen.We present a technique that allows for the complete isolation of the mesorectum from the same position of the robotic cart,during the process,the enhanced dexterity and precise dissection offered by the Da Vinci surgical system were fully utilized.