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Prospective Analysis of Autonomic Nerve Preserving Robotic Rectal Cancer Surgery Using Indian SSI Mantra Robot: A
Kushal Agrawal1, Ashwin K R1, Rohitkumar C1
1Department of Surgical Oncology, Aster International Institute of Oncology, Aster CMI Hospital, New Airport Road, No. 43/2NH 44, Sahakar Nagar, Hebbal, Bengaluru, Karnataka 560092 India.
Indian Journal of Surgical Oncology
|July 1, 2026
Summary
The Indian SSI Mantra Robot offers a safe and effective approach for minimally invasive rectal cancer surgery, achieving excellent oncologic and functional outcomes comparable to established robotic systems. This study supports its broader use in colorectal procedures.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Minimally invasive surgery (MIS) has transformed rectal cancer treatment, improving recovery and reducing complications.
- Total mesorectal excision (TME) is the gold standard, prioritizing nerve preservation for essential functions.
- Robotic systems enhance surgical precision, particularly in the challenging pelvic anatomy of rectal cancer surgery.
Purpose of the Study:
- To evaluate the safety and efficacy of the Indian SSI Mantra Robot for rectal cancer surgery.
- To assess intraoperative, postoperative, and functional outcomes in patients undergoing robotic TME.
- To compare the performance of the SSI Mantra Robot with established robotic platforms.
Main Methods:
- A prospective study involving 92 patients with rectal adenocarcinoma undergoing robotic surgery with the SSI Mantra system.
- Detailed analysis of port placement, patient positioning, and nerve-preserving dissection techniques.
- Evaluation of oncologic outcomes (R0 resection, lymph node yield) and functional outcomes (bladder, sexual function).
Main Results:
- High R0 resection rate (98.9%) with adequate lymph node harvest (mean 21).
- Favorable early recovery: 98% oral diet on day 1, low morbidity (15% total), and no mortality.
- Functional outcomes: ~10% bladder dysfunction, ~20% sexual dysfunction; average hospital stay 4.9 days.
- Oncologic and functional outcomes were comparable to the Da Vinci robotic system.
Conclusions:
- The Indian SSI Mantra Robot is a safe and effective platform for minimally invasive rectal cancer surgery.
- It delivers excellent oncologic and functional results, comparable to established robotic systems.
- The study supports wider adoption of the SSI Mantra Robot in colorectal MIS.
