Abstract
In recent decades, surgery for rectal cancer has evolved from an operation normally
performed under poor vision with a lot of blood loss, relatively high morbidity, and
mortality to a safer operation. Currently, minimally invasive rectal procedures are
performed with limited blood loss, reduced morbidity, and minimal mortality. The main
cause is better knowledge of anatomy and adhering to the principle of operating along
embryological planes. Surgery has become surgery of compartments, more so than that
of organs. So, rectal cancer surgery has evolved to mesorectal cancer surgery as propagated
by Heald and others. The focus on the mesentery of the rectum has led to renewed attention
to the anatomy of the fascia surrounding the rectum. Better magnification during laparoscopy
and improved optimal three-dimensional (3D) vision during robot-assisted surgery have
contributed to the refinement of total mesorectal excision (TME). In this chapter,
we describe how to perform a robot-assisted TME with particular attention to the mesentery.
Specific points of focus and problem solving are discussed.
Keywords
robot-assisted total mesorectal excision - surgical technique - mesentery
