An Institutional Shift from Routine to Selective Diversion of Low Anastomosis in Robotic TME Surgery for Rectal Cancer Patients Using the KHANS Technique: A Single-Centre Cohort Study.

(1) Background: In recent years, there has been a change in practice for diverting stomas in rectal cancer surgery, shifting from routine diverting stomas to a more selective approach. Studies suggest that the benefits of temporary ileostomies do not live up to their risks, such as high-output stomas, stoma dysfunction, and reoperation. (2) Methods: All rectal cancer patients treated with a robotic resection in a single tertiary colorectal centre in the UK from 2013 to 2021 were analysed.

Role of robotic approach in ileal pouch-anal anastomosis (IPAA): A systematic review of the literature.

Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become standard surgical treatment of choice in patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP) in which the medical management fails. Despite the wide use of laparoscopic method, the enhanced and innovative features that come with the robotic platform, such as endo-wrist technology, 3D visualization, surgeon-controlled camera and motion scaling, make it an appealing choice. This study aims to investigate the feasibility and safety of robotic approach for proctectomy or proctocolectomy with IPAA as compared to conventional laparoscopic approach.

Robotic CME in obese patients: advantage of robotic ultrasound scan for vascular dissection.

Complete mesocolic excision (CME) in right-sided colon cancers appears to confer oncological benefits compared to conventional colectomy. Identification of the superior mesenteric vein (SMV) remains challenging. We describe the novel use of intra-operative robotic ultrasound scan (rUSS) in obese patients (BMI ≥ 29).

Self-assembling peptide haemostatic gel reduces incidence of pelvic collection after total mesorectal excision: Prospective cohort study.

Background: Pelvic surgery has the potential to leave behind a large raw surface, which can bleed and ooze postoperatively. The adoption of precision surgical approach for rectal cancers has led to reduction in blood loss. We aimed to assess 1) the feasibility and 2) the safety of using a self-assembling peptide (SAP) haemostatic agent (PuraStat®) after rectal cancer surgery to reduce the incidence of pelvic collections.

Robotic surgery for colorectal cancer in the Octogenarians.

Background: We evaluated the short-term outcomes of robotic colorectal cancer surgery in octogenarian patients, focussing on postoperative morbidity and survival.

Methods: All patients ≥80 years in a prospective colorectal cancer database undergoing robotic curative colorectal cancer resection were included. Patient demographics, intraoperative findings, postoperative and oncological outcomes were recorded.

Robotic Complete Mesocolic Excision (CME) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience.

Background: Complete mesocolic excision (CME) for right colon cancers has traditionally been an open procedure. Surgical adoption of minimal access CME remains limited due to the technical challenges, training gaps and lack of level-1 data for proven benefits. Currently there is limited published data regarding the clinical results with the use of robotic CME surgery.

Laparoscopic right posterior sectionectomy (LRPS): surgical techniques and clinical outcomes.

Background: Right posterior sectionectomy is one of the most technically challenging laparoscopic liver resections. Currently, there is limited published data regarding the technique and results required to better understand its safety and feasibility.

Aim: To report our experience, results and techniques, highlighting a variety of tips and tricks to facilitate this resection.

Laparoscopic parenchymal sparing resections in segment 8: techniques for a demanding and infrequent procedure.

Background: Laparoscopic liver resections for lesions in the postero-superior segments are technically demanding due their deep location and relation with the vena cava. However, previous reports have demonstrated the feasibility and safety of these resections in centres with advanced experience in laparoscopic liver surgery. In this case series, we present our results and experience of laparoscopic parenchymal sparing liver resections of lesions in segment 8.

Benefit of rectal washout for anterior resection and left sided resections.

Purpose: To assess the effectiveness of rectal wash out in preventing local recurrence for patients who undergo anterior resection for recto-sigmoid cancer.

Materials And Methods: A best evidence topic was constructed according to a structured protocol. Medline 1948-2015 and EMBASE 1980 to 2015 using the OVID interface: ( Rectal) AND (Washout) AND (Anterior Resection).

Short- and long-term outcomes for patients with splenic flexure tumours treated by left versus extended right colectomy are comparable: a retrospective analysis.

Purpose: To compare the outcomes of colonic splenic flexure tumours treated by extended right colectomy versus left colectomy.

Methods: Stage I-III splenic flexure tumours, treated either by extended right colectomy or left colectomy between 1996 and 2011, were identified in a prospective database, and the short- and long-term outcomes compared. The survival analyses were performed using the Kaplan-Meier method and adjusted using a Cox-proportional hazard model.

Short- and long-term outcomes after laparoscopic versus open emergency resection for colon cancer: an observational propensity score-matched study.

Background: Case series suggest the feasibility and safety of emergency resection of colon cancer by laparoscopy. The present study compares short- and long-term outcomes of laparoscopic and open resection for colon cancers treated as emergencies.

Methods: The study was a propensity score-matched design based on a prospective database.