| There are still many difficult problems to solve in rectal cancer surgery. The local recurrence should be decreased more without any toxic adjutant therapy. On that basis, we should preserve the urogenital function more. The magnified view of the operative field is great advantage to the rectal cancer surgery. However, it is difficult to move the forceps precisely in deep pelvis because of their characteristics in the laparoscopic surgery.Between November 2011 and Feburary 2017, we performed 580 robotic surgery for rectal cancer. There were 436 anterior resections, 92 intersphincteric resections, 52 abdominoperineal resections. Robotic surgery was superior to laparoscopic surgery in a hospital stay, blood loss conversion rate and frequency of urinary retention.In Japan, lateral lymph node dissection is the standard treatment for locally advanced lower rectal cancer. This is because the incidence of lateral pelvic lymph node metastasis from lower rectal cancer is 20%. Lateral lymph node dissection for advanced lower rectal cancer is a good indication of robotic surgery because of its much higher degree of difficulty. The indication of the lateral lymph node dissection is lower rectal cancer with T3 or T4. Lower rectal cancer was defined as rectal cancer below the peritoneal reflection. We performed 197 robotic surgeries with lateral lymph node dissection for lower advanced rectal cancer. |
