Robot-assisted radical right hemicolectomy with transcolonic specimen extraction employing endoscopic techniques: The first case report with video presentations

Abstract

Background

Natural Orifice Specimen Extraction Surgery (NOSES) garners international acclaim for expediting recovery and mitigating incision-related complications, witnessing increased medical significance. While NOSES in right colon cancer surgery, primarily via transvaginal route, parallels open surgery outcomes, its gender-specific limitations persist.

Methods

This report delineates three pioneering cases of Robot-Assisted Radical Hemicolectomy coupled with Transcolonic Specimen Extraction (RRH-TCSE), executed meticulously under full laparoscopic guidance. Procedures spanned 180–203 minutes, with blood loss meticulously managed at 50–100ml, exemplifying the apex of minimally invasive surgery. An intricate technique involved specimen extraction via the colon, navigated transanally post-colonoscopic passage from the transected transverse colon to the rectum, illustrating complete intracorporeal retrieval.

Results

All patients were discharged swiftly between postoperative days 8–10, exhibiting rapid, complication-free recovery, forecasting favorable prognoses. Follow-ups until June 2024 confirmed no recurrence or metastasis across 6-18-month observation spans. Maintained anal function, unobstructed defecation, and enhanced aesthetics from omitted abdominal incisions optimized patient comfort and satisfaction.

Conclusions

This study documents the first employment of robot-assisted, totally laparoscopic right hemicolectomy through the colonic pathway. RRH-TCSE emerges as a surgical breakthrough, furnishing a novel, dependable intervention for both genders with substantial potential to enhance patient quality of life in the future.