| International Session (Symposium) 6 (JSGS・JSGE・JGES) |
| Fri. November 2nd 14:40 - 17:00 Room 13: Kobe International Conference Center International Conference Room |
| Robotic surgery for low rectal cancer | |||
| Yusuke Kinugasa1, Takatoshi Matsuyama1, Shinichi Yamauchi1 | |||
| 1Department of Gastrointestinal Surgery, Tokyo Medical and Dental University | |||
|
|||
|
|||
| 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. Since daVinci surgical system was approved by FDA in 2000, robotic surgery became widespread. Robotic-assisted total mesorectal excision for rectal cancer were reported in 2006. The characteristics of the robot, that is, high quality 3-dimensional image and sensitive, complicated manipulation of forceps enabled surgery in the narrow pelvic cavity easy. Robotic surgery was superior to laparoscopic surgery in a hospital stay, blood loss conversion rate and frequency of urinary retention in our case. Moreover, in robotic surgery, we can mobilize the rectum into the anal canal easily. And recent daVinci system has good stapler. Therefore, even in very low rectal cancer which was indication for ISR could be performed LAR. 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. |
|||
|
Index Term 1: Robotic surgery Index Term 2: Rectal cancer |
|||
| Page Top | |||