Abstract
Since the performance of the first laparoscopic cholecystectomies in the mid-1980s, several barriers have been surpassed regarding the limits of minimally invasive techniques on many surgical procedures. Particularly, because of several limitations of laparoscopic technology, such as dexterity of laparoscopic instruments, ergonomic limitations for the surgeons, and a long learning curve, minimally invasive techniques were not massively applied for complex procedures such as colonic resections, with or without anastomosis, until several years later, excluding, this way, a large number of patients from the benefits of minimally invasive surgery.
Laparoscopic colectomy has demonstrated clear benefits over open surgery in colorectal procedures: faster recovery of bowel function, less intraoperative bleeding, and shorter hospital stay, among others, while offering similar oncological outcomes. Laparoscopic procedures require dexterity from the surgeon and have a steep learning curve. The resection of the rectum for cancer is even more challenging because of the narrow pelvic space and several neurovascular structures involved that must be preserved in order to offer patients better results in postoperative quality of life. But concerns regarding the limitations of laparoscopy such as rigid instruments, bidimensional views of the operative field, and limited movements have been drawbacks for the routine application of minimally invasive techniques in colorectal procedures.
The development of the da Vinci Surgical System (Intuitive Surgical Inc., Mountain View, CA, USA) gives surgeons instruments able to execute a wide range of motions and eliminate physiological tremor, therefore allowing the surgeons to perform finer dissections, particularly in narrow spaces such as pelvic cavity. The magnified 3D views of the operative field are helpful to preserve structures that otherwise when resected negatively affect the procedure’s outcomes and therefore the patient’s well-being.
The use of the robotic technology in colorectal surgery allows surgeons to overcome the limitations of the conventional laparoscopy and it is particularly useful when working in the pelvic cavity and the rectum, bringing additional benefits to patients in their postoperative quality of life.
This chapter analyzes the use of robotic devices in colorectal surgery and the possible benefits for patients in terms of postoperative status and quality of life.
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Notes
- 1.
Pfannenstiel is a type of abdominal surgical incision that allows the surgeon to have access to the abdomen. It is mainly used in Caesarian sections.
- 2.
- 3.
ASA is a subjective assessment of a patient’s health. The assessment is based on five classes (I to V) of physical health as identified by the American Society of Anesthesiologists.
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Wilson Mourad, A., Daniel León, D. (2021). Robotic Colon Surgery and Quality of Life. In: Kouraklis, G., Matsiota, E.(. (eds) Laparoscopic Colon Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-56728-6_7
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DOI: https://doi.org/10.1007/978-3-030-56728-6_7
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