Comparison of robotic and laparoscopic total mesorectal excision / 中华胃肠外科杂志

ABSTRACT

Laparoscopic total mesorectal excision (TME) has been commonly applied in the operation of mid-low rectal cancer, but the conventional laparoscopic TME has the disadvantages of major operative difficulty and long learning-curve, due to its limitations of 2-dimension vision and common laparoscopic instruments. Robotic surgical system with high-qualified 3-dimenstion vision and flexible Endo Wrist instruments can overcome those limitations of conventional laparoscopy, and is useful for the TME that demands deep pelvic operation and flexible dissection in the space of distal rectum. Robotic TME has the advantages of shorter learning curve and lower conversion rate, and it can even be performed by the surgeon with little laparoscopic experience. But according to the current studies, the superiority of robotic TME over laparoscopic TME can not be confirmed. To confirm the efficacy of robotic surgery, more high-level evidences are needed. Currently, the biggest obstacle for the widespread use of robotic surgical system is its high expense. But there is an obvious advantage that is the more comfortable feeling of surgeon while performing robotic surgical system, compared with performing laparoscopic operation, and it is helpful for long-time complicated operation. It is confirmative that robotic operation is the results of science and technology development, and it is the direction of future development. With the expiration of patent right of Da Vinci robotic system, there will be more kinds of robotic surgical systems which will lead to the much lower operation expense and the widespread use. The young surgeons should master the laparoscopic TME, which will help them master robotic TME technique quickly.