Rectal surgery

Wissam J Halabi, Mehraneh Jafari, Alessio Pigazzi

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Rectal surgery has always constituted a technical challenge. The deep confines of the pelvis as well as the limited space, especially in male patients, make surgical dissection a technically difficult task. The ability to achieve sound oncologic resection without injuring adjacent structures adds to the complexity of the procedure. Unfortunately, these technical challenges were not overcome by the introduction of laparoscopic techniques in the 1990s. The limited degree of freedom of traditional laparoscopy as well as the two-dimensional pictures has contributed to the slow adoption of laparoscopy in rectal surgery. The introduction of robotic-assisted surgery in rectal operations in the early 2000s has helped overcome many of the technical limitations of traditional laparoscopy. Several reports have addressed the feasibility, safety and outcomes of robotic-assisted rectal surgery for cancer and prolapse. In what follows, we will be giving a brief overview on rectal anatomy, rectal cancer and prolapse. The surgical management of these two entities will be discussed focusing on the robotic approach. The use of robotic-assistance in rectal surgery, its potential advantages, disadvantages, indications and contraindications will be presented. Technical details of each procedure will be presented as well as outcomes. Robotic-assisted rectal surgery represents a new and rapidly growing field of robotic surgery. Despite increased cost, this technique is safe and is associated with shorter length of hospital stay, and a faster recovery compared to the open technique. Compared to the laparoscopic technique, robotic rectal surgery has the added benefit of lower conversion rates, lower blood loss, and a lower incidence of sexual and urinary dysfunction which are relatively common complications in rectal surgery. In addition to the short-term benefits of robotic-assisted rectal surgery, the long-term oncologic outcomes appear similar to the open and laparoscopic techniques.

Original languageEnglish (US)
Title of host publicationRobotic Surgery for the General Surgeon
PublisherNova Science Publishers, Inc.
Pages201-228
Number of pages28
ISBN (Electronic)9781629489575
ISBN (Print)9781629489551
StatePublished - Jan 1 2014
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Halabi, W. J., Jafari, M., & Pigazzi, A. (2014). Rectal surgery. In Robotic Surgery for the General Surgeon (pp. 201-228). Nova Science Publishers, Inc..