Robotic interface for transabdominal division of the levators and pelvic floor reconstruction in abdominoperineal resection: A case report and technical description

Sung U. Bae, Avanish P. Saklani, Hyuk Hur, Byung S. Min, Seung H. Baik, Nam K. Kim

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Extralevator abdominoperineal resection (APR) in a prone jackknife position was developed to avoid a positive circumferential resection margin, and its application led to lower rates of local recurrence. The paper describes a technique of robotic extralevator APR with transabdominal levator division followed by pelvic floor reconstruction with bilayered composite mesh. Methods: A 42-year-old man with low rectal cancer required APR that was performed in a lithotomy position with transabdominal division of the levators. After the perineal phase, the robot was redocked and a bilayered composite mesh was sutured to the pelvic inlet using robotic needle drivers. Results: The specimen had a cylindrical shape, and there was no surgical waist or perforation. Histology revealed a ypT2N0 tumor without circumferential margin involvement. Conclusions: The robotic interface can aid in APR by accurately transecting the levators from the top. Additionally, it allows suturing of mesh around the pelvic inlet to prevent perineal hernias.

Original languageEnglish
Pages (from-to)296-301
Number of pages6
JournalInternational Journal of Medical Robotics and Computer Assisted Surgery
Volume11
Issue number3
DOIs
Publication statusPublished - 2015 Sep 1

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Pelvic Floor
Robotics
Prone Position
Histology
Composite materials
Rectal Neoplasms
Hernia
Needles
Tumors
Robots
Recurrence
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Biophysics
  • Computer Science Applications

Cite this

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abstract = "Background: Extralevator abdominoperineal resection (APR) in a prone jackknife position was developed to avoid a positive circumferential resection margin, and its application led to lower rates of local recurrence. The paper describes a technique of robotic extralevator APR with transabdominal levator division followed by pelvic floor reconstruction with bilayered composite mesh. Methods: A 42-year-old man with low rectal cancer required APR that was performed in a lithotomy position with transabdominal division of the levators. After the perineal phase, the robot was redocked and a bilayered composite mesh was sutured to the pelvic inlet using robotic needle drivers. Results: The specimen had a cylindrical shape, and there was no surgical waist or perforation. Histology revealed a ypT2N0 tumor without circumferential margin involvement. Conclusions: The robotic interface can aid in APR by accurately transecting the levators from the top. Additionally, it allows suturing of mesh around the pelvic inlet to prevent perineal hernias.",
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Robotic interface for transabdominal division of the levators and pelvic floor reconstruction in abdominoperineal resection : A case report and technical description. / Bae, Sung U.; Saklani, Avanish P.; Hur, Hyuk; Min, Byung S.; Baik, Seung H.; Kim, Nam K.

In: International Journal of Medical Robotics and Computer Assisted Surgery, Vol. 11, No. 3, 01.09.2015, p. 296-301.

Research output: Contribution to journalArticle

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