Robotic‐assisted low anterior resection: beyond total mesorectal excision; a left vascular approach with presacral fascia excision – a video vignette

2020 ◽  
Vol 22 (5) ◽  
pp. 595-596 ◽  
Author(s):  
S. Kumar ◽  
J. Rohila ◽  
S. P. Sasi ◽  
U. Tantravahi ◽  
Dharmakumar K. G. ◽  
...  
Keyword(s):  
Total Mesorectal Excision ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Mesorectal Excision ◽  
Robotic Assisted ◽  
Video Vignette ◽  
Presacral Fascia

scholarly journals Robotic versus transanal total mesorectal excision in sexual, anorectal, and urinary function: a multicenter, prospective, observational study

2021 ◽  
Author(s):  
Julia-Kristin Grass ◽  
Roberto Persiani ◽  
Flavio Tirelli ◽  
Chien-Chih Chen ◽  
Marco Caricato ◽  
...  
Keyword(s):  
Sexual Function ◽  
Total Mesorectal Excision ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Functional Results ◽  
Transanal Total Mesorectal Excision ◽  
Urinary Function ◽  
Mesorectal Excision ◽  
Term Survival ◽  
Lars Score

Abstract Purpose Improved long-term survival after low anterior resection (LAR) for rectal cancer highlights the importance of functional outcome. Urogenital and anorectal dysfunction is frequently reported after conventional LAR. Advanced minimally invasive techniques such as robotic (RoTME) and transanal total mesorectal excision (TaTME) might improve functional results by precisely dissecting and preserving autonomic nerves. We compared functional outcomes after RoTME or TaTME in a multicenter study. Methods One hundred twenty patients (55 RoTME/65 TaTME) were prospectively included in four participating centers. Anorectal (Wexner and low anterior resection syndrome (LARS) Score), urinary (International Consultation on Incontinence—Male/Female Lower Urinary Tract Symptoms Score (ICIQ-MLUTS/ICIQ-FLUTS) and International Prostate Symptom Scale (IPSS)), and sexual (International Index of Erectile Function (IIEF), Female Sexual Function Index (FSFI)) outcomes at 12 months after surgery were compared to preoperative scores. The response rate to the 1-year postoperative functional assessment by questionnaire was 79.5%. Results RoTME enabled better anorectal function compared to TaTME (LARS score 4.3 ± 2.2 vs. 9.8 ± 1.5, p = 0.038, respectively). TaTME proved superior at preserving male urinary function, while female urinary function was comparable in both groups, with only mild postoperative impairment (RoTME vs. TaTME, respectively: ICIQ-MLUTS 13.8 ± 4.9 vs. 1.8 ± 5.8, p = 0.038; ICIQ-FLUTS Incontinence Score − 0.3 ± 1.0 vs. − 0.2 ± 0.9, p = 0.844). Both techniques demonstrated comparable male (RoTME − 13.4 ± 2.7 vs. TaTME − 11.7 ± 3.4, p = 0.615) and female (RoTME 5.2 ± 4.6 vs. TaTME 10.5 ± 6.4, p = 0.254) sexual function. Conclusion After adjustment for risk factors, RoTME provided better anorectal functional results, whereas TaTME was better at preserving male urinary function. Overall, both techniques demonstrated only mild postoperative functional impairment.

Push-Back Technique Facilitates Ultra-Low Anterior Resection without Nerve Injury in Total Mesorectal Excision for Rectal Cancer

2011 ◽  
Vol 28 (4) ◽  
pp. 239-244 ◽  
Author(s):  
Yasuhiro Inoue ◽  
Junichiro Hiro ◽  
Yuji Toiyama ◽  
Koji Tanaka ◽  
Keiichi Uchida ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Nerve Injury ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Mesorectal Excision
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