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Role of robotic natural orifice specimen extraction surgery in colorectal neoplasms
Hongliang Yao1, Tiegang Li1, Weidong Chen1
1Department of General Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
Abstract:
Natural orifice specimen extraction surgery (NOSES) is especially suitable for colorectal surgery. Until now, most of the reports published were about laparoscopic NOSES, the reports about robotic NOSES are extremely rare. This study aims to explore the safety and feasibility of robotic NOSES for colorectal neoplasms. All patients underwent robotic NOSES from March 2016 to October 2019 in our hospital were enrolled for retrospective analysis. Clinicopathological data including patient characteristics, perioperative information and pathological information were collected and analyzed. According to the distance between tumor and anus or whether neoadjuvant chemoradiotherapy (nRCT) is performed, we grouped the cases and studied its influence on robotic NOSES. Also, we compared the previous reports on laparoscopic NOSES with our study and revealed advantages of robotic NOSES in terms of safety and feasibility. A total of 180 patients were enrolled. The average distance from the lower edge of the tumor to the anus was (8.64 ± 3.64) cm and maximum circumferential diameter (CDmax) of specimen was (3.5 ± 1.6) cm. In terms of safety, the average operation time, intraoperative blood loss, and postoperative hospital stay were (187.5 ± 78.3) min, (47.4 ± 34) mL, and (11.3 ± 7.5) days, respectively. In terms of feasibility, the average number of lymph node harvested was (14.8 ± 5). Robotic NOSES shows advantages in terms of safety and feasibility compared with laparoscopic NOSES. This procedure could not only be a safe procedure but also could achieve good oncological outcomes.
Insights
Robotic Natural Orifice Specimen Extraction Surgery (NOSES) is safe and feasible for colorectal neoplasms. This robotic approach offers advantages over laparoscopic NOSES, achieving good oncological outcomes.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Natural orifice specimen extraction surgery (NOSES) is a minimally invasive technique particularly suited for colorectal procedures.
- While laparoscopic NOSES has been reported, robotic applications remain rare.
- This study investigates robotic NOSES for colorectal neoplasms.
Purpose of the Study:
- To evaluate the safety and feasibility of robotic Natural Orifice Specimen Extraction Surgery (NOSES) for colorectal neoplasms.
- To compare the outcomes of robotic NOSES with existing laparoscopic NOSES data.
- To identify factors influencing robotic NOSES outcomes, such as tumor proximity to the anus and neoadjuvant chemoradiotherapy (nRCT).
Main Methods:
- Retrospective analysis of 180 patients who underwent robotic NOSES for colorectal neoplasms between March 2016 and October 2019.
- Collection and analysis of clinicopathological data, including patient characteristics, perioperative information, and pathological findings.
- Grouping patients based on tumor-anus distance and nRCT status to assess their impact on robotic NOSES outcomes.
Main Results:
- The average tumor-anus distance was 8.64 cm, and the maximum specimen circumferential diameter was 3.5 cm.
- Key safety metrics included an average operative time of 187.5 minutes, blood loss of 47.4 mL, and a postoperative hospital stay of 11.3 days.
- Feasibility was demonstrated by an average of 14.8 lymph nodes harvested, with robotic NOSES showing advantages over laparoscopic approaches in safety and feasibility.
Conclusions:
- Robotic Natural Orifice Specimen Extraction Surgery (NOSES) is a safe and feasible option for treating colorectal neoplasms.
- The robotic approach demonstrates superior safety and feasibility compared to laparoscopic NOSES.
- Robotic NOSES can achieve favorable oncological outcomes, representing a promising advancement in minimally invasive colorectal surgery.
