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Abdalla et al. Mini-invasive Surg 2019;3:39 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.38

Original Article Open Access

Robotic-assisted abdominoperineal resection:
technique, feasibility, and short-term outcomes

Solafah Abdalla , Alain Valverde , Jean-François Fléjou , Nicolas Goasguen , Olivier Oberlin , Renato
1
2
1
1
1
Micelli Lupinacci 1
1 Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris 75020, France.
2 Service d'Anatomie Pathologique, Hôpital Saint Antoine, Paris 75012, France.
Correspondence to: Dr. Renato Micelli Lupinacci, Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint-
Simon, 125, rue d’Avron, Paris 75020, France. E-mail: rmlupinacci@gmail.com
How to cite this article: Abdalla S, Valverde A, Fléjou JF, Goasguen N, Oberlin O, Lupinacci RM. Robotic-assisted abdominoperineal
resection: technique, feasibility, and short-term outcomes. Mini-invasive Surg 2019;3:39.
http://dx.doi.org/10.20517/2574-1225.2019.38

Received: 27 Sep 2019 First Decision: 12 Nov 2019 Revised: 29 Nov 2019 Accepted: 12 Dec 2019 Published: 26 Dec 2019
Science Editor: Nicola de'Angelis Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: The use of robotic-assisted laparoscopy seems fully adapted to pelvic surgery. However, few studies focus on
robotic-assisted abdominoperineal resection (RAAPR). The aim of this study was to assess the feasibility, short-
term postoperative outcomes, and pathological results of RAAPR. In addition, we provide a detailed description of
the operative procedure and a brief review of the current literature.

Methods: Between January 2013 and April 2018, we performed a total of 428 robotic surgeries, including 294
colorectal resections (68.7%). Data were prospectively collected and included demographics, intraoperative
findings, postoperative outcomes, and pathological data. For this study, we included the first 20 consecutive
RAAPRs performed with the four-arm da Vinci Si surgical system (Intuitive Surgical Inc., Sunnyvale, CA, USA).

Results: Twenty patients (nine men) with a mean age of 68 years and a mean BMI of 24.5 ± 5.0 kg/m underwent
2
RAAPR for low rectal adenocarcinoma (80%) or squamous cell carcinoma of the anal canal. Sixteen (80%) patients
underwent preoperative pelvic radiotherapy and eight (40%) had a history of previous abdominal surgery. Mean
operative duration was 218 ± 52 min. There was no conversion to open surgery. Mortality, reoperation, and morbidity
rate were 5%, 25%, and 60%, respectively. Three (15%) patients presented perineal complications. Mean length of
hospital stay was 20 days. Three (15%) patients had pT4 tumor. Mesorectal excision was considered complete in
90%. On average, 16.5 ± 7.2 lymph nodes were retrieved.

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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