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Robotic taTME using the da Vinci SP: technical notes in a cadaveric model.

Dario Ribero¹, Diana Baldassarri², Giuseppe Spinoglio³

¹Program of Hepatobiliary, Pancreatic and Colorectal Surgery, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov.le 142, km. 3,95, 10060, Candiolo, TO, Italy. dario.ribero@ircc.it.

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This study demonstrates the technical feasibility of robotic transanal total mesorectal excision (taTME) using the da Vinci SP system. This approach may overcome limitations of traditional laparoscopic surgery for rectal cancer.

Area of Science:

Surgical Oncology
Robotic Surgery
Gastrointestinal Surgery

Background:

Transanal total mesorectal excision (taTME) is an advanced technique for rectal cancer treatment.
The da Vinci SP (dVSP) system offers a single-port robotic platform for minimally invasive procedures.

Purpose of the Study:

To assess the technical feasibility of robotic taTME using the da Vinci SP (dVSP) system in a preclinical setting.
To evaluate the dVSP system's capability in performing the transanal phase of taTME for rectal cancer.

Main Methods:

A proof-of-concept preclinical study utilizing two fresh cadavers (one male, one female).
Simulation of two clinical scenarios with tumor locations at 1 cm and >4 cm above the anorectal junction.
Utilized GelPOINT Path for transanal access, incorporating a 2.5 cm single-port robotic trocar and a 10 mm sleeve.

Keywords:

Rectal cancer Robotic surgery Single port Transanal TME

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Main Results:

Complete transanal total mesorectal excision was successfully performed in both cadavers.
Intact mesorectal fascia was confirmed post-dissection in both cases.
Procedure times averaged 106-124 minutes, with approximately 15 minutes for robot setup.

Conclusions:

Robotic taTME using the da Vinci SP (dVSP) system is technically feasible for rectal cancer treatment.
The dVSP system shows potential to address limitations associated with conventional laparoscopic taTME.
This preclinical study supports further investigation into robotic taTME for improved rectal cancer surgery.