Robotic Low Anterior and Abdominoperineal Resection: Hybrid Technique

Rectal cancer surgery represents one of the most challenging procedures in colorectal surgery. In particular, the minimally invasive approaches to rectal dissection pose significant challenges because of difficulty in accessing the low pelvis, lack of instrument articulation, inadequate retraction and camera stability. Robotic technology holds the potential to address some of these technical challenges and has been increasingly employed for rectal applications over the past decade. In this chapter we will review the technique of hybrid laparoscopic-robotic total mesorectal low anterior resection, a procedure that is particularly favored by experienced laparoscopic colorectal surgeons who have consistently found the best application for the robot to be in pelvic dissections.