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Streamlining robotic-assisted abdominoperineal resection
Kazunosuke Yamada1, Jun Imaizumi2, Ryuji Kato2
1Department of Gastroenterological Surgery, Gunma Prefectural Cancer Center, 617-1, Nishimachi, Oota-Shi, Gunma, 373-0828, Japan. kazuyama@gunma-cc.jp.
World Journal of Surgical Oncology
|December 21, 2023
Summary
This study optimized robot-assisted abdominoperineal resection (APR) by streamlining team composition and using a synchronous approach. This method reduces operative time and blood loss in rectal cancer surgery.
Area of Science:
- Surgical Oncology
- Robotic Surgery
Background:
- Robot-assisted surgery (RAS) is safe for rectal cancer abdominoperineal resection (APR).
- RAS for APR can lead to longer operative times and increased costs.
- Optimized team composition and synchronous approach can mitigate RAS limitations.
Purpose of the Study:
- To overcome limitations of longer operative times and higher costs in robot-assisted APR.
- To evaluate a synchronous approach with optimized team composition for robot-assisted APR.
- To improve efficiency in rectal cancer surgical management.
Main Methods:
- Analysis of robot-assisted APR cases (June 2022-June 2023).
- Implementation of a synchronous approach with optimized team roles.
- Specific techniques included perineal anococcygeal ligament resection concurrent with port setup and presacral fascia incision via console manipulation.
Main Results:
- Median operation time reduced significantly.
- Intraoperative blood loss was minimized.
- Two cases (22.2%) experienced Clavien-Dindo grade II surgical site infections; no urinary or erectile dysfunction reported.
Conclusions:
- Streamlined team composition and synchronous approach efficiently address challenges in robot-assisted APR.
- Optimization minimizes the need for larger surgical teams.
- Maximized utilization of surgical time and resources achieved without additional personnel.
