Shifting Paradigms in Minimally Invasive Surgery: Applications of Transanal Natural Orifice Transluminal Endoscopic Surgery in Colorectal Surgery

Recently, a robotic system was developed in the biomedical field to support minimally invasive surgery. The popularity of minimally invasive surgery has surged rapidly because of endoscopic procedures. In endoscopic surgery, surgical procedures are performed within a body cavity and visualized with laparoscopy or thoracoscopy. Since the initial laparoscopic cholecystectomy was performed in 1987, the implications for endoscopic procedures have continuously expanded, and endoscopic surgery is currently the standard for an increasing number of operations. Advances in laparoscopic surgery have led to less postoperative pain, shorter hospital stays, and an earlier return to work for many patients. However, performing laparoscopic procedures requires several skills that have never been required for conventional open surgery. The surgeon needs to coordinate his/her eyes and hands and acquire a skillful manner using long-shaft instruments as well as mentally interpret a two-dimensional environment as a three-dimensional one. Because learning such skills is stressful for most surgeons, performing a laparoscopic procedure is more physically and mentally demanding than performing an open procedure.

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Robotic colorectal surgery: Where are we right now?

Proceedings of the Institution of Mechanical Engineers Part C Journal of Mechanical Engineering Science ◽

10.1243/09544062jmes2065 ◽

2010 ◽

Vol 224 (7) ◽

pp. 1415-1419 ◽

Cited By ~ 3

Author(s):

J Kang ◽

K Y Lee

Keyword(s):

Minimally Invasive Surgery ◽

Robotic Surgery ◽

Colorectal Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Degrees Of Freedom ◽

Three Dimensional ◽

Colorectal Disease ◽

Widespread Application ◽

Robotic Colorectal Surgery

Minimally invasive surgery has become mainstream in surgical management of colorectal disease. Based on evidence of oncologic safety and benefit to patients, laparoscopic colorectal surgery is regarded as a successful alternative to open surgery. Since the introduction of the da Vinci® system as another tool for minimally invasive surgery, there have been several reports regarding the feasibility and safety of the system. The authors looked at their experience with 412 robotic colorectal surgeries and found that it was feasible and safe. Incidence of operation-related morbidity was around 11 per cent and system-related problems were 2.4 per cent. There was no operation-related or system-related mortality. From a technological perspective, robotic surgery has several advantages over laparoscopic surgery, including a magnifying view with a three-dimensional image, a stable camera platform, and instruments with Endowrist® technology that allow for seven degrees of freedom of movement. However, there is still room for improvement. The revolution of robotic technology can aid in the realization of a dream: a smaller, cheaper, and more sophisticated robotic system, which will further facilitate the widespread application of robotic surgery to colorectal disease.

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