Introduction
Materials and methods
Literature review
Expert perspective
Results
Literature review
Author year | n | Study design | Robot | Indications | Conversion to other technique | Complications | OR time | EBL | Positioning | Defect closed |
---|---|---|---|---|---|---|---|---|---|---|
Morino 2022 [6] | 26 | Retrospective cohort | Flex robotic system | Benign adenoma, early rectal adenocarcinoma | TEO (n = 6) | Bleeding requiring transfusion (n = 2), local recurrence (n = 2) | Median: 115 min (range: 45–360) | Negligible | Supine (n = 16), Prone (n = 10) | Yes |
Marks 2021 [7] | 26 | Phase II clinical trial | DV single port | Benign polyp, select rectal cancer (T1, < / = T2 after neoadjuvant therapy) | TEM (n = 2), laparoscopic low anterior resection (n = 1) | Pelvic abscess (n = 1), wound dehiscence (n = 3), peritoneal entry (n = 5) | Avg: 198.8 min (87–552) | Avg: 24.2 mL (range 0-185 mL) | Supine modified lithotomy (n = 25), prone (n = 1) | Yes |
Studniarek 2021 [13] | 1 | Case report | DV single port | Rectal neuroendocrine tumor | No | – | – | – | Right lateral decubitus | – |
Lo 2022 [11] | 16 | Case series | DV Xi | Tubulovillous adenoma, rectal adenocarcinoma | No | Incontinence (n = 1), presacral abscess (n = 1), rectal abscess (n = 1) | Avg: 87 min (IQR 54.75- 109.5) | Avg 17.5 mL (IQR 8.75-20 mL) | Lithotomy (n = 2), prone jackknife (n = 14) | Yes |
Marks 2021 [9] | 2 | Case report | DV single-port | Endoscopically unresectable neoplastic polyps (serrated adenoma, tubulovillous adenoma) | No | None | Avg: 180.5 min (207, 154 min) | Avg: 15 mL (0, 30 mL) | Prone (n = 1), modified lithotomy (n = 1) | Yes |
*Paull 2020 [8] | 21 | Case series | DV Si (n = 10), Flex robotic system (n = 11) | Early rectal neoplasia (T0-T1, N0) | Laparoscopic TAMIS (n = 3), transabdominal approach (n = 1) | DV Si: fractured mass (n = 1), proctotomy (n = 1). Flex: case aborted (n = 1) | DV Si: avg 167.6 ± 84.2 min (range 101–361) Flex: 110.1 ± 39.9 min (range 55–180) | DV Si: avg 37.5 ± 38.3 mL (range 5–100) Flex: 9.1 ± 13.6 mL (range 5–50) | Prone jackknife or high lithotomy for both DV Si and Flex | Yes |
*Arnott 2018 [10] | 10 | Case series | DV S-type | Early stage rectal cancer (T0–T1, N0) | Laparoscopic TAMIS (n = 2), traditional TAE (n = 1), robotic abdominal approach (n = 1) | Rectal stenosis requiring dilation (n = 1), peritoneal entry (n = 1) | 167 ± 26 min (101–361 min) | 37.5 ± 11.6 mL (range 5–100 mL) | Lithotomy or prone jackknife | Yes |
Ngu 2018 [18] | 6 | Prospective cohort | DV Xi | Locally advanced rectal carcinoma (cT3/4 ± N, 0 M) after neoadjuvant CRT | No | None | Median 106.5 min (range 69–217 min) | Minimal | Modified lithotomy | Yes |
Paull 2018 [17] | 1 | Case report | Flex robotic system | Submucosal anterior mass, suggestive of GIST | No | None | – | – | – | Yes |
Atallah 2014 [19] | 1 | Case report | DV Si | Poorly differentiated adenocarcinoma (pT1) | No | None | 93 min | Negligible | Modified lithotomy with moderate Trendelenburg | Yes |
Bardakcioglu 2013 [20] | 1 | Case report | DV | Recurrent rectal adenoma | No | None | – | – | Lithotomy | Yes |
Buchs 2013 [12] | 3 | Prospective cohort | DV Si | Incomplete excision of T1 adenocarcinoma | No | Peritoneal entry (n = 1) | Mean 110 min (range 90–120 min, s.d. 17.3) | Mean 6.7 ± 2.9 mL | Left or right lateral position | Yes |
Author year | n | Study design | Robot | Indications | Final pathology | Surgical margins |
---|---|---|---|---|---|---|
Morino 2022 [6] | 26 | Retrospective cohort | Flex robotic system | Benign adenoma (22/26), early rectal adenocarcinoma (4/26) unsuitable for endoscopic removal | Benign adenoma (16/26), early rectal adenocarcinoma (8/26), no histology-proven clear resection margins (2/26) | Positive (n = 4), Negative (n = 22) |
Marks 2021 [7] | 26 | Phase II clinical trial | DV single port | Benign polyp (16/26), select rectal cancer (10/26) (T1, < / = T2 after neoadjuvant therapy) eligible for local excision | Adenocarcinoma (10/26) with T0 (n = 3), T1 (n = 3), T2 (n = 2), T3 (n = 1), T4 (n = 1). 7/10 received neoadjuvant chemotherapy; adenoma (14/26), GIST (1/26), carcinoid tumor (1/26) | Negative (n = 26) |
Studniarek 2021 [13] | 1 | Case report | DV single port | Rectal neuroendocrine tumor | Rectal neuroendocrine tumor, grade 1 pT1aNxMx | – |
Lo 2022 [11] | 16 | Case series | DV Xi | Endoscopically unresectable tubulovillous adenoma, rectal adenocarcinoma | Negative for tumor (4/16), tubulovillous adenoma (4/16), tubulovillous adenoma with high-grade dysplasia (4/16), invasive rectal adenocarcinoma (4/16) | Negative (n = 16) |
Marks 2021 [9] | 2 | Case report | DV single-port | Endoscopically unresectable neoplastic polyps (serrated adenoma, tubulovillous adenoma) | Serrated adenoma (1/2) and tubulovillous adenoma (1/2) | Negative (n = 2) |
*Paull 2020 [8] | 21 | Case series | DV Si (n = 10), Flex robotic system (n = 11) | Early rectal neoplasia (T0-T1, N0) | Neuroendocrine tumor (1/21), tubular adenoma (7/21), villous adenoma (1/21), tubulovillous polyp with adenomatous dysplasia (7/21), GIST (1/21), adenocarcinoma (4/21) | Negative (n = 20) |
*Arnott 2018 [10] | 10 | Case series | DV S-type | Early stage rectal cancer (T0-T1, N0) | Neuroendocrine cells (1/10), tubular adenoma (3/10), tubulovillous/villous polyps with adenomatous dysplasia (4/10), adenocarcinoma (2/10) | Negative (n = 10) |
Paull 2018 [17] | 1 | Case report | Flex robotic system | Submucosal anterior mass, suggestive of GIST | Low-grade GIST (1/1) | – |
Ngu 2018 [18] | 6 | Prospective cohort | DV Xi | Locally advanced rectal carcinoma (cT3/4 ± N, 0 M) after neoadjuvant CRT | – | – |
Atallah 2014 [19] | 1 | Case report | DV Si | Poorly differentiated adenocarcinoma (pT1) | Sessile serrated adenoma (1/1) | – |
Buchs 2013 [12] | 3 | Prospective cohort | DV Si | Incomplete excision of T1 adenocarcinoma | T1 adenocarcinoma (3/3) | Negative (n = 3) |
Bardakcioglu 2013 [20] | 1 | Case report | DV | Recurrent rectal adenoma | Villous adenoma without dysplasia (1/1) | Negative (n = 1) |