Seminars in Colon & Rectal Surgery RSS feed: Current Issue. Seminars in Colon and Rectal Surgery offers a comprehensive and coordinated review of a single, timely topic related to the diagnosis and treatment of proctologic diseases. Each issue is an organized compendium of practical information that serves as a lasting reference for colorectal surgeons, general surgeons, surgeons in training and their colleagues in medicine with an interest in colorectal disorders. 2009 Topics March Anal Reconstruction Feza H. Remzi June Anal Fistula David N. Armstrong September Mesh in Colorectal Surgery Najjia Mahmoud December Robotic Colorectal Surgery Leela Prasadhttp://www.seminarscolonrectalsurgery.com/?rss=yesElsevier Inc.en © 2009 Elsevier Inc. All rights reserved. Seminars in Colon & Rectal Surgery1043-1489204December 2009 © 2009 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.seminarscolonrectalsurgery.com/article/PIIS1043148909000384/abstract?rss=yesThe relevance of this issue of Seminars in Colon and Rectal Surgery on “Robotics in Colorectal Surgery” cannot be overemphasized. With the use of robotic assistance in prostatic surgery rapidly emerging as a standard of care, the application of robotic technology in other surgical disciplines is gaining increasing importance.IntroductionLeela M. Prasad, Sonia L. Ramamoorthy10.1053/j.scrs.2009.08.001Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7155155http://www.seminarscolonrectalsurgery.com/article/PIIS1043148909000402/abstract?rss=yesSurgical robots, although relatively new, have developed quickly. The development of surgical robots is reviewed in this article. The surgical robots have applications in many surgical specialties. The most widely used surgical robotic system is the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) that is based on an immersive, “master-slave” paradigm which enhances the surgeon's abilities. Surgical robotics is changing rapidly, and any development in surgical robots in future will allow greater application of robotic devices to increasingly more difficult procedures and hard to access anatomical sites, with significant improvement in patient outcomes.Robotics: Past, Present, and Future ConsiderationsMyriam J. Curet10.1053/j.scrs.2009.08.003Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7156161http://www.seminarscolonrectalsurgery.com/article/PIIS1043148909000414/abstract?rss=yesRobotic surgery is a growing field that has introduced a new range of instruments, procedures, and protocols into the standard OR suite. The safety and efficiency of robotic assistance in surgical practice depend significantly on the presence of a consistent, trained, and experienced nursing staff and OR team. Establishing a robotic coordinator position goes a long way in optimal OR scheduling, timely procurement of instruments, training of nursing staff, and in collaborating between surgeons across multiple services.Setting Up a Robotic Surgery Program: A Nurse's PerspectiveCindy Mahal van Brenk10.1053/j.scrs.2009.08.004Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7162165http://www.seminarscolonrectalsurgery.com/article/PIIS1043148909000426/abstract?rss=yesRobotic colectomy has been shown to be a feasible and safe procedure. Although left-sided colectomy and proctectomy have received the most attention in robotics application, the advantages of robotic technology apply equally to resection of the right colon. A description of a technique for robotic right hemicolectomy with intracorporeal anastomosis is presented, and it addresses some of the inherent limitations of current robotic systems. The potential advantages and disadvantages of robotics for right colon surgery are also discussed.Robotics: Right ColonDavid Jayne10.1053/j.scrs.2009.08.005Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7166172http://www.seminarscolonrectalsurgery.com/article/PIIS1043148909000463/abstract?rss=yesThere are many potential advantages of using robotics for resection of the left colon and the sigmoid colon. These include stable traction of the vascular pedicles, preservation of the aortic and the hypogastric nerve plexus, improved accessibility for take-down of the splenic flexure, and easily applicable intracorporeal colorectal or colocolic anastomosis. This chapter provides a detailed description of the technique used in a robotic dissection for a left colectomy or sigmoidectomy.Robotics: Left Colon and Sigmoid ResectionSeon H. Kim10.1053/j.scrs.2009.08.009Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7173176http://www.seminarscolonrectalsurgery.com/article/PIIS1043148909000438/abstract?rss=yesVarious surgical options exist for patients with pelvic organ prolapse. Conventionally, open procedures have been performed laparoscopically with similar results and fewer morbidity. However, widespread use of laparoscopy to treat rectal and vaginal vault prolapse has been limited by the technical challenges of performing these surgeries with a minimally invasive approach. Robotic surgery allows for improved visualization and ergonomics, enabling the surgeon to perform complicated procedures more easily. Robotically assisted laparoscopic rectopexies and sacrocolpopexies have been shown to have excellent results but they increase operative time and cost. Further investigation is needed to demonstrate clear advantages to using this approach over conventional laparoscopy.Robotics for Pelvic Floor Disorders: Rectopexy and Pelvic Organ ProlapseMadhulika G. Varma10.1053/j.scrs.2009.08.006Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7177180http://www.seminarscolonrectalsurgery.com/article/PIIS104314890900044X/abstract?rss=yesRobotic surgery has many features that make it superior to traditional laparoscopic surgery. However, the use of the robot is limited by the need to reposition the robot during colon and rectal operations encompassing more than one abdominal quadrant. A “hybrid” technique has been developed which combines traditional laparoscopy with a robotic pelvic dissection. With this combined approach, the benefits of the 2 techniques can be maximized, while minimizing their limitations.Hybrid Laparoscopic-Robotic Low Anterior ResectionJennifer Blumetti, Ashwin L. deSouza, Leela M. Prasad10.1053/j.scrs.2009.08.007Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7181184http://www.seminarscolonrectalsurgery.com/article/PIIS1043148909000670/abstract?rss=yesThe intended application of robotics in surgery was in the field of cardiac surgery. The addition of robot was thought to improve surgeon dexterity in a small field with the added advantage of a minimal invasive approach. Shortly thereafter, urologists recognized that this modality could be used in the deep pelvis and brought the robot to its current most widely used application, the robotic prostatectomy. In the subsequent years, the use of this technology for other “pelvic organs” such as the uterus, rectum, and bladder evolved. Similarly, during this time period, minimally invasive surgical techniques were being studied in colorectal surgery. The results of the Clinical Outcomes of Surgical Therapy trial in 2004 concluded that laparoscopic approaches to colon cancer could be performed without compromise of oncological or quality of life outcomes (Fleshman J, Sargent DJ, Green E, et al; for the Clinical Outcomes of Surgical Therapy Study group: Ann Surg 246:655-662, 2007). Current meta-analyses have yet to show a significant oncological advantage to laparoscopic colon surgery; however, many studies have demonstrated short-term benefits with early mobilization, reduced pain, and early discharge (Kuhry E, Schwenk WF, Gaupset R, et al: Cochrane Database Syst Rev 3:CD003145, 2005). Recent data have shown that between 6% and 10% of colon surgeries are performed using laparoscopic techniques in the United States (Kemp JA, Finlayson SR: Surg Endosc 22:1181-1187, 2008). With wider acceptance of these techniques, the natural evolution within the field of colorectal surgery was to apply them to rectal cancer surgery.Robotic Assisted Rectal Cancer SurgerySonia Ramamoorthy10.1053/j.scrs.2009.10.009Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7185189http://www.seminarscolonrectalsurgery.com/article/PIIS1043148909000451/abstract?rss=yesSince the concept of minimally invasive surgery was introduced, advances in technology have broadened laparoscopic approaches to the gastrointestinal tract. In particular, the development of robotic surgery has provided surgeons with greater comfort and the ergonomic tools necessary to overcome some of the limitations associated with conventional laparoscopic surgery. The da Vinci robotic system has been widely used in urological and gynecologic surgery and has now expanded into gastrointestinal procedures, including colorectal surgery. However, the robotic approach carries its own potential set of complications. This review will summarize the complications associated with robotic-assisted colorectal surgery in the current published report as well as robotic surgical failures seen when using the da Vinci robotic system.Complications of Robotic Total Mesorectal ExcisionJeong-Heum Baek, Shaun McKenzie, Alessio Pigazzi10.1053/j.scrs.2009.08.008Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7190194http://www.seminarscolonrectalsurgery.com/article/PIIS1043148909000499/abstract?rss=yesOver the last few years, robotics has emerged from the field of minimally invasive surgery as a technique capable of addressing some of the difficulties associated with traditional laparoscopic colorectal surgery. As with any new technology, robotics presents new challenges and requires technical troubleshooting by experienced surgeons. This article reviews the technical issues that are commonplace in colorectal robotic procedures and describes available solutions.Troubleshooting in Robotic Colorectal SurgeryPier C. Giulianotti, Francesco M. Bianco, Pietro Addeo10.1053/j.scrs.2009.09.002Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7195200http://www.seminarscolonrectalsurgery.com/article/PIIS1043148909000396/abstract?rss=yesAs robotic technology becomes more commonplace, the demand for structured training programs in robotic surgery will increase. Every new technology has its learning curve and robotic surgery is no exception. The ideal training program in robotic surgery should progress from laboratory exercises to a mentored clinical experience in patients. This review presents the reported experience on teaching robotic surgery, suggests protocols for training colorectal surgeons as well as elaborates on the tools to objectively measure technical proficiency.Robotic Colorectal Surgery—Teaching and Skill AcquisitionSlawomir J. Marecik, Ashwin L. deSouza, Leela M. Prasad10.1053/j.scrs.2009.08.002Seminars in Colon & Rectal Surgery 20, 4 (2009)2009-12-01Seminars in Colon & Rectal Surgery2009-12-01204S1043-1489(09)X0004-7201206