Robotic-assisted low anterior resection with trans-anal extraction and single stapled-anastomosis: a bridge toward natural orifice rectal surgery: P068

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Aim:Robotic technology has advantages in rectal cancer surgery. Wepresent a novel technique for robotic low anterior resection (LAR)/total mesorectal excision (TME) consisting of transanal specimen extraction, double purse string, and single stapled circular anastomosis (TRADOSS) without an abdominal incision. This studypresents our technique and initial results.Method:The charts of patients undergoing the TRADOSS technique were reviewed. A robotic TME is followed by opening of the rectum distal to the tumour and delivery of the specimen transanaly. Theproximal bowel is divided at the perineum and a purse string is placed manually. The colon with the anvil is pushed back into the pelvis and second purse string is placed robotically on the rectal stump. A stapled circular anastomosis is performed.Results:Three patients underwent robotic TRADOSS between 2009 and 2010 for low and mid rectal cancers. Mean operating time was 310 minutes. There were no conversions and no intraoperative complications. Mean length of stay was 5 days. There were no anastomotic leaks.Conclusion:This study shows the feasibility of TRADOSS, a novel technique for robotic LAR. Thisprocedure may be a bridge toward natural orifice surgery and help reduce anastomotic complications of rectal surgery.

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