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Updated: May 21, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Toumai robotic system in uterine cancer surgery: first report of sentinel lymph node dissection in ten steps
Matteo Pavone1,2,3, Maria Consiglia Giuliano1, Chiara Innocenzi1,2
1Gynaecology Oncology Unit, Department of Women's and Children's Health Sciences and Public Health, Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy.
Background:
In recent years, robotic surgery has gained traction across multiple disciplines, establishing a new minimally invasive paradigm. After the Da Vinci® (Intuitive, Sunnyvale, California) patent expired, several platforms with increasingly digital interfaces entered the market. Robotic surgery may represent a bridge between laparoscopy and digital surgery through interfaces that enable integration with emerging technologies. Among platforms, the Toumai robotic system (Medbot-Microport, Shanghai, China) features a single-arm cart with four arms, a three-dimensional console, and a split-view "picture-in-picture" function enabling communication with image-guided surgical technologies. This functionality is particularly valuable for indocyanine green (ICG)-guided sentinel lymph node (SLN) mapping in gynaecologic oncology.
Objectives:
We present for the first time, a step-by-step video demonstration of SLN dissection for endometrial malignancies using the Toumai robotic system.
Participant:
A postmenopausal patient with uterine-confined endometrial carcinoma undergoing total hysterectomy, bilateral salpingo-oophorectomy, and bilateral SLN biopsy.
Intervention:
The technique includes: 1) ICG injection; 2) robotic trocar placement; 3) docking; 4) pelvic retroperitoneal access; 5) switch to split-view mode; 6) identification of the SLN critical view of safety by developing pararectal and paravesical spaces; 7) introduction of an ICG-capable camera through an accessory trocar; 8) activation of near-infrared visualisation after switching off the robotic light source; 9) SLN identification and dissection; 10) safe extraction.
Conclusions:
The digital interface of the Toumai system integrates adjunctive technologies, illustrating how next-generation robotics expand the feasibility of SLN dissection in endometrial cancers.
What Is New?:
The Toumai platform enables SLN dissection even in the absence of an in-house integrated ICG endoscopic camera.
