Implementation of a robotic single-staple technique for colorectal anastomosis: Technical description and initial institutional experience

Abstract

Anastomotic leakage remains one of the most relevant complications after low rectal surgery, with a considerable negative impact on morbidity, mortality, quality of life, and healthcare resources. The widely adopted double-stapling technique is limited by technical drawbacks, particularly the intersection of staple lines, which creates areas of structural weakness and has been associated with an increased risk of leakage. To address these limitations, single-stapling techniques have been developed, including transanal transection with single-stapled anastomosis (TTSS) and other variants. We report our initial institutional experience with the robotic variant of the single-stapled anastomosis. A retrospective analysis was performed including 49 patients who underwent low anterior resection, comparing the double-stapled anastomosis (n = 40) with the robotic single-stapled anastomosis (n = 9), assessing 30-day postoperative complications, anastomotic leakage, and length of hospital stay.