Robotic-assisted minimally invasive surgery for rectal cancer. Experience at the National Cancer Institute – Colombia

Resumen

Introduction. The treatment of colorectal tumors requires a comprehensive approach, with surgical resection as the primary focus, usually accompanied by neoadjuvant chemo-radiotherapy. The advantages of the robotic approach have allowed to gain an important place in rectal surgery, considering it a safe and reliable approach for these patients.

Methods. This is an observational, retrospective study that included patients diagnosed with rectal cancer who underwent robotic assisted surgery at the National Institute of Cancerology between 2017 and 2023. Surgeries were performed by a single console surgeon and various surgeons-in-training as assistants.

Results. A total of 43 patients were included in the study. 69.7% of patients had a tumor in the lower rectum, 20.9% in the middle rectum, and only 7.2% in the upper rectum. Low anterior or ultra-low anterior rectal resection was performed in 58.1% of patients and TaTME in 34.9%.The quality of the mesorectum was complete in 79%, almost complete in 18.6% and no patients had an incomplete mesorectum. Postoperative complications: 20.9%; 6.9% (n=3) had Clavien-Dindo complications >IIIa. Anastomotic leak rate: 9.3%.

Conclusion. Robotic surgery for rectal cancer may be technically advantageous compared to other techniques. It is a safe and feasible technique in Latin American countries, achieving optimal oncological results. In this report we highlight the results in the most important component of disease-free survival (negative CRM), which has determined its incorporation as the technique of choice in patients with rectal cancer in our institution.