講演情報
[IL2]Robotic Surgery：Advancing Minimally Invasive Surgery for Colorectal Cancer
George J. Chang (Professor and Chair ad interim, Department of Colon and Rectal Surgery Associate Vice President, Regional Surgery Strategy The University of Texas, MD Anderson Cancer Center)
Minimally invasive surgery is a well-established standard of care for patients with colorectal cancer and has been associated with better short term outcomes and with a potentially lower risk for long term surgical morbidity such as bowel obstruction and hernia. Several randomized trials have shown the oncologic equivalence of minimally invasive surgery for colon cancer but there has been more controversy regarding the oncologic outcomes following minimally invasive surgery for rectal cancer. Much of the challenge for performing minimally invasive surgery is due to the anatomic limitations for performing high-quality laparoscopic rectal cancer surgery within a narrow pelvis, particularly in obese male patients or those with locally advanced disease requiring extended lymphadenectomy or multi-visceral resection.
Robotic surgery has advanced minimally invasive surgery by facilitating particularly more difficult resections due to patient or tumor factors resulting in a democratization of minimally invasive surgery for more patients, particularly in Western countries where obesity is a greater problem. Robotic surgery for rectal cancer has also been associated with lower rates of conversion in high-risk patients, and more recently associated with better short-term oncologic, and functional outcomes when compared to laparoscopic surgery. In addition, robotic surgery has facilitated performance of advanced surgery including lateral pelvic lymph node dissection and multivisceral resection with low morbidity.
In recent years, several new platforms for robotic surgery have been developed and technology continues to evolve, hopefully resulting in decreased costs and greater accessibility of robotic surgery to more patients around the world.
Robotic surgery has advanced minimally invasive surgery by facilitating particularly more difficult resections due to patient or tumor factors resulting in a democratization of minimally invasive surgery for more patients, particularly in Western countries where obesity is a greater problem. Robotic surgery for rectal cancer has also been associated with lower rates of conversion in high-risk patients, and more recently associated with better short-term oncologic, and functional outcomes when compared to laparoscopic surgery. In addition, robotic surgery has facilitated performance of advanced surgery including lateral pelvic lymph node dissection and multivisceral resection with low morbidity.
In recent years, several new platforms for robotic surgery have been developed and technology continues to evolve, hopefully resulting in decreased costs and greater accessibility of robotic surgery to more patients around the world.