Left Colectomy and Segmental Resections for Cancer

Abstract

One of the goals of surgical oncology is to attempt to reduce the invasiveness of surgery while maintaining or further improving the outcomes of traditional open surgery. Therefore minimally invasive techniques have been applied to oncologic surgery since the end of 90s, on the basis of the good clinical results obtained by laparoscopic surgery in some benign diseases. The diffusion of laparoscopic colonic surgery has increased in recent years thanks to specific educational and training programs, but mainly in academic and high-volume hospitals [1]. The most frequently-performed procedures are the less difficult, such as sigmoidectomy for benign diseases and right colectomies with extracorporeal anastomosis [2]. Despite the improvement of technology some disadvantages of standard laparoscopy are still present, such as poor ergonomics, the difficulty to perform intracorporeal sutures and the problem of the assistant being able to hold the camera stable. Robotic surgery is an emerging technique that seems to overcome some difficulties of the standard laparoscopic approach, and its use in colorectal cancer is increasing quickly [3]. In this chapter, the technical details of robotic left colectomy and segmental colonic resections are reported.