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First clinical experience with single-port robotic transanal minimally invasive surgery (SP rTAMIS) for benign rectal neoplasms

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Abstract

Background

The new da Vinci Single-Port (SP) robot is a single-arm four-channel robotic system well suited for endoluminal surgery. We report our initial experience performing SP robotic transanal minimally invasive surgery (SP rTAMIS) for rectal neoplasms.

Methods

Under Institutional Review Board approval, two patients with rectal neoplasms were prospectively enrolled for elective SP rTAMIS. The primary endpoint was to report the safety and feasibility of successful procedure completion with the SP robot. Secondary endpoints included patient characteristics and perioperative metrics.

Results

Both patients underwent successful SP rTAMIS resection of rectal neoplasms without intraoperative complications or conversions. The lesions were 4.0 cm and 3.0 cm in size, located 6 cm and 7 cm cephalad to the anorectal ring. Excisions were full thickness with no piecemeal extractions or specimen fragmentation. Estimated blood loss was 0 mL and 30 mL. The mean excised area was 13.4 cm2 (22.7 cm2 and 9.0 cm2). The mean docking time was 5.25 min (range 2–8 min) and mean console time was 122.5 min (98 min and 147 min). Patients tolerated a liquid diet on postoperative day (POD) 0 and were discharged on POD 1 after tolerating a low residue diet and having bowel function. Pathology showed two adenomas with negative margins. There was no immediate or delayed morbidity or mortality.

Conclusions

Our initial experience indicates that SP rTAMIS is a safe and feasible approach for local excision of rectal lesions. While SP rTAMIS is very promising, more experience with this approach is necessary to determine its widespread applicability.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Division of Colorectal Surgery, Marks Colorectal Surgical Associates, Lankenau Medical Center, Medical Science Building, Suite 375, 600 East Lancaster Avenue, Wynnewood, PA, 19096, USA

    J. H. Marks, E. Kunkel, J. F. Salem, C. Martin, B. Anderson & S. Agarwal

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  1. J. H. Marks
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  2. E. Kunkel
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  3. J. F. Salem
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  4. C. Martin
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  5. B. Anderson
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  6. S. Agarwal
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Correspondence to J. H. Marks.

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Conflict of interest

Dr. Marks has served as a consultant for intuitive surgical. All other authors have no conflicts of interest to declare.

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All authors have reviewed and abide by the ethical responsibilities and COPE guidelines.

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Informed consent was obtained from all individual participants included in the study.

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Marks, J.H., Kunkel, E., Salem, J.F. et al. First clinical experience with single-port robotic transanal minimally invasive surgery (SP rTAMIS) for benign rectal neoplasms . Tech Coloproctol 25, 117–124 (2021). https://doi.org/10.1007/s10151-020-02358-8

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  • DOI: https://doi.org/10.1007/s10151-020-02358-8

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