Gastroenterologie
a hepatologie

Simultaneous robotic resection of colorectal cancer and liver metastases – first experience

Vladimír Teplan¹, Jiří Chrobok¹, Aaron Rulseh², Ronald Pospíšil¹

+ Affiliation
¹ Centrum robotické chirurgie, Chirurgické oddělení, Nemocnice Na Homolce, Praha
² Radiodiagnostické oddělení, Nemocnice Na Homolce, Praha

Summary

Robotic surgery is a rapidly emerging surgical technique worldwide, which has a number of advantages in comparison to the majority of surgical procedures used so far (shorter hospital stay, faster recovery, less pain at the surgical site, fewer surgical site infections, lower risk of incisional hernia and fewer conversions). We present a patient with colorectal cancer in the hepatic flexure and solitary hepatic metastasis (segment 2). Right-sided hemicolectomy with intracorporeal side-to-side anastomosis was performed with the DaVinci Xi robotic system, as well as robotic resection of the second hepatic segment, without the necessity of changing the location (docking) of the robotic instruments. Use of the minimally invasive robotic technique and ERAS protocol significantly accelerated postoperative recovery, including recovery of peristalsis, reduced the need for analgesics, and the patient was discharged on the 5th postoperative day.

Keywords

colorectal cancer, liver metastases, robotic surgery

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Literature

1. Kune GA, Kune S, Field B et al. Survival in patients in large bowel cancer: a population based investigation from Melbourne colorectal cancer study. Dis Colon Rectum 1990; 33(11): 938–946. doi: 10.1007/ BF02139103.
2. Faivre J, Rat P, Arveux P. Epidemiologie des metastases hepatiques des cancers de colon. In: Nordlinger B, Jaeck D (eds). Traitment des metastases hepatiques des cancers colorectaux. Paris: Springer Verlag 1992: 2–9.
3. Epidemiologie zhoubných nádorů v ČR. 2023 [online]. Dostupné z: https:/ / www.svod.cz/ .
4. Cohen MC, Minsky BD, Schilsky RI. Cancer of the colon. In: De Vita VT, Hellman s, Rosenberg SA (eds). Cancer, principles and practice in oncology. Philadelphia: JB Lippincott 1993: 1144–1197.
5. Genova P, Pantuso G, Abdalla S et al. Milestones in robotic colorectal surgery development: an historical overview. Mini-invasive Surg 2020; 4: 2. doi: 10.20517/ 2574-1225.2019.30.
6. Longmore SK, Naik G, Gargiulo GD. Laparoscopic Robotic Surgery: Current Perspective and Future Directions. Robotics 2020; 9(2): 42. doi: 10.3390/ robotics9020042.
7. Veverková L, Čapov I, Vlček P et al. „State of art“ robotická chirurgie. Endoskopie 2010; 19(1): 17–20.
8. Kim CW, Kim CH, Baik SH. Outcomes of Robotic-Assisted Colorectal Surgery Compared with Laparoscopic and Open Surgery: a Systematic Review. J  Gastrointest Surg 2014; 18(4): 816– 830. doi: 10.1007/ s11605-014-2469-5.
9. İmamoğlu Gİ, Oğuz A, Cimen S et al. The impact of lymph node ratio on overall survival in patients with colorectal cancer. J Cancer Res Ther 2021; 17(4): 1069–1074. doi: 10.4103/ jcrt.JCRT-11-19.
10. Škrovina M, Macháček M, Martínek L et al. Resekce rekta s totální excizí mezorekta – laparoskopicý versus robotický přístup. Rozhl Chir 2021; 100(11): 527–532. doi: 10.33699/ PIS.2021. 100.11.527–533.
11. Odermatt M, Ahmed J, Panteleimonitis S et al. Prior experience in laparoscopic rectal surgery can minimise the learning curve for robotic rectal resections: a cumulative sum analysis. Surg Endosc 2017; 31(10): 4067–4076. doi: 10.1007/ s00464-017-5453-9.
12. Langer D, Vocka M, Kalvach J et al. Roboticky asistovaná léčba zhoubných nádorů kolorekta a hepatopankreatobiliární oblasti. Gastroent Hepatol 2021; 75(5): 410–416. doi: 10.48095/ ccgh2021410.
13. Jíšová B, Skořepa J, Pastor J et al. Výsledky robotické kolorektální chirurgie na III. chirurgické klinice FNM. Gastroent Hepatol 2023; 77(2): 154–157. doi: 10.48095/ ccgh2023154.
14. Machairas N, Dorovinis P, Kykalos S et al. Simultaneous robotic-assisted resection of colorectal cancer and synchronous liver metastases: a systematic review. J Robor Surg 2021; 15(6): 841–848. doi: 10.1007/ s11701-021-01213-8.
15. McGuirk M, Gachabayov M, Rojas A et al. Simultaneous robot assisted colon and liver resection for metastatic colon cancer. JSLS 2021; 25(2): e2020.00108. doi: 10.4293/ JSLS.2020.00 108.
16. Rahimli M, Perrakis A, Schellerer V et al. Robotic and laparoscopic liver surgery for colorectal liver metastases: an experience from a German Academic Center. World J Surg Oncol 2020; 18(1): 333. doi: 10.1186/ s12957-020-02113-1.
17. Garritano S, Sevaggi F, Spampinato MG. BioMed Research International Vol. 2016; 932825 
18. Ho CM, Wakabayashi G, Nitta H et al. Systematic review of robotic liver resection. Surg Endosc 2013; 27(3): 732–739. doi: 10.1007/ s00464-012-2547-2.
19. Shapera E, Ross S, Crespo K et al. Analysis of surgical approach and tumor distance to marginal free liver resection for colorectal liver metastasis. J Robot Surg 2022; 16(6): 1427–1439. doi: 10.1007/ s11701-022-01387-9.
20. Dwyer RH, Scheidt M, Marshall S et al. Safety of synchronous robotic surgery for colorectal cancer with liver metastasis. J Robot Surg 2018; 12(4): 603–606. doi: 10.1007/ s11701-018-08 13-6.