Minireviews
Copyright ©The Author(s) 2021.
World J Gastrointest Surg. Aug 27, 2021; 13(8): 834-847
Published online Aug 27, 2021. doi: 10.4240/wjgs.v13.i8.834
Table 1 Technical details of the series reporting robotic transanal total mesorectal excision
Ref.
Period of study
n
Robotic platform
Transanal interface
Patients' position
Type of Robotic TaTME
Teams
Remarks
Atallah et al[25], 201311da Vinci SiGelPOINT pathDorsal lithotomyRobotic-assisted11st robotic TaTME
Verheijen et al[26], 20141da VinciGelPOINT pathLithotomyRobotic-assisted1
Gómez Ruiz et al[29], 2015August 2013 January 20145da Vinci SiTransanalLithotomyTotally robotic11st totally robotic TaTME
Access Port +
GelPOINT
Atallah et al[30], 2015November 2011 August 20144da Vinci SiGelPOINT pathDorsal lithotomyRobotic-assisted1
Atallah et al[31], 20151da Vinci SiGelPOINT + LonestarDorsal lithotomyRobotic-assisted21st robotic ISR + TaTME
Huscher et al[32], 2015January 2014 April 20147da Vinci SiGelPOINT pathRobotic-assisted1
Kuo et al[33], 2017July 2015 March 201615da Vinci SiGelPOINT pathLithotomy 15º trendelenburgTotally robotic1Robotic SSPO
Hu et al[34], 2020January 2016 November 201620daVinci XiGelPOINT pathLithotomyRobotic-assisted2
Monsellato et al[35], 2019May 2017 October 20173da Vinci SiGelPOINT pathDorsal lithotomyRobotic-assisted1 (2)
2 (1)
Tan et al[36], 2020September 20191Robotic-assisted2Laparoscopic SSPO
Suhardja et al[37], 20201da Vinci XiLone Star +Lloyd-DaviesTotally robotic1
GelPOINT path
Ye et al[38], 2021May 2017 January 202013da Vinci SiSTARport pathLithotomy trendelenburgTotally robotic (9)1 (9)
Robotic-assisted (4)2 (4)
Table 2 Demographic and preoperative data, n (%)
Ref.
n
Male/female
Age (yr)
BMI (kg/m2)
Tumor DAV (cm)
Clinical stage (I/II/III/IV)
Neoadjuvant treatment
Type
Verheijen et al[26], 201410/1 (100)4823.680/0/1/01 (100)CRT
Gómez Ruiz et al[29], 201554 (80)/1 (20)57 ± 13.9125.8 ± 2.715 (4-6)21/0/4/04 (80)CRT
Atallah et al[30], 201543 (75)/1 (25)44 (26-59)229 (21-38)21/0/3/03 (75)CRT
Atallah et al[31], 201511 (100)/06631.6< 0.431/0/0/00
Huscher et al[32], 201573 (42.9)/4 (57.1)63.2 ± 9.7129.9 ± 6.112 (1–6.5)45/2/0/00
Kuo et al[33], 2017157 (46.7)/8 (53.3)60.3 (44–75)421.973.3 (2.0–5.0)411 (73.3)CRT
Hu et al[34], 20202013 (65)/7 (35)56.3 ± 14.4123.9 ± 3.415.8 ± 2.614/4/10/212 (60)CRT 9 (45)RT 3 (15)
Monsellato et al[35], 201932 (66.6)/1 (33.3)61 (55–68)226 (25–28)24.33 (3-6)20/0/3/03 (100)CRT
Tan et al[36], 202011 (100)/07124.0830/0/1/01 (100)CT
Suhardja et al[37], 202011 (100)/06760/0/1/01 (100)CRT
Ye et al[38], 2021139 (69.2)/4 (30.8)62 (42- 67)522.26 (20.90–24.08)54.5 (4- 6)51/2/10/011 (84.6)CRT
Table 3 Intraoperative and postoperative outcomes, n (%)
Ref.
OT, min     
TransanalOT, min
Abdominal OT, min
Blood loss, mL
Splenic flexure mobilization
Transanal specimen extraction
Defunctioning stoma
Anastomosis method (H/S/E)1
Anastomosis height (n)
Intraoperative complications
Conversion
Postoperative complications
Length of stay, d
Mortality
Verheijen et al[26], 20142056550Yes1 (100)1 (100)100%/0%/0%ColorectalNoNoNo30%
Gómez Ruiz et al[29], 2015398 ± 882123 ± 502112 ± 27290 ± 502Yes5 (100)5 (100)40%/60%/0%Coloanal (2); Colorectal (3)NoNo1 (20)6 ± 120%
Atallah et al[30], 2015376 (140-409)3200 (50-300)3Yes3 (75)75%/0%/25%Coloanal (3)NoNo3 (75)4.3 (4-5)30%
Atallah et al[31], 2015316751 (100)100%/0%/0%Coloanal (1)NoNoNo0%
Huscher et al[32], 2015165.7 ± 54.4255.5 ± 12.42Yes7 (100)7 (100)0%/100%/0%Coloanal (7)NoNo1 (14.29)4.8 ± 0.620%
Kuo et al[33], 20167473 (335–569)433 (30–50)415 (100)5 (33.3)100%/0%/0%Coloanal (15)1 (6.7)2 (13.3) to laparoscopic2 (13.3)12.2 ± 1.520%
Hu et al[34], 2020172.3 ± 24.2282.0 ± 107.12Yes (25)L-colostomy 6 (30); L-ileostomy 8 (40)10%/80%/10%Coloanal (2); Colorectal (16)1 (5)No7 (35)8.8 ± 4.220%
Monsellato et al[35], 2019530 (440–600)3InconsistentYes3 (100)3 (100)100%/0%/0%Coloanal (3)NoNoNo10.6 (7-15)30%
Tan et al[36], 202013220NoNoNo60%
Suhardja et al[37], 202021050160No1 (100)0%/100%/0%Colorectal (1)NoNoNo50%
Ye et al[38], 2021240 (195–270)595 (74–100)560 (50–100)5Yes13 (100)12 (92.3)61.5%/38.5%/0%Coloanal (9); Colorectal (4)NoNo3 (23.1)7 (6–10)50%
Table 4 Detail of postoperative complications
Ref.

Gómez Ruiz et al[29], 2015Grade B anastomotic leak diagnosed in the outpatient clinic on postoperative day 14
Atallah et al[30], 2015Sub-segmental pulmonary embolism
Dehydration related to high output from his diverting ileostomy that required readmission 3 wk postoperatively
Wound hematoma requiring drainage 2 wk postoperatively
Huscher et al[32], 2015Rectal bleeding requiring the transfusion of blood units without reoperation
Kuo et al[33], 2017Laparoscopic adhesiolysis for postoperative intestinal obstruction
Superficial wound infection
Hu et al[34], 2020Postoperative Ileus with Conservative treatment
Pelvic abscess treated with antibiotics
Acute urinary retention that required reinsertion of Foley catheter
Perineal wound bleeding that needed hemostasis
Duodenal ulcer bleeding with conservative treatment
Fever with unknown origin with conservative treatment
Acute appendicitis managed with antibiotics
Ye et al[38], 2021Anastomotic leakage grade B on postoperative day 3History of duodenal ulcer with duodenal hemorrhage on postoperative day 7 solved with conservative treatment
Postoperative ileus treated with gastrointestinal decompression and parenteral nutrition
Table 5 Pathologic, oncological, and functional outcomes
Ref.
Tumor size, cm
Quality TME (I/II/III), %
CRM +
Distal margin +
Harvested nodes
DAV, cm      
CRM, cm
Follow-up, mo
Local recurrence
Distant progression, m
Functional (urinary/sexual)
Verheijen et al[26], 2014100/0/0NoNo2
Gómez Ruiz et al[29], 2015100/0/0NoNo14 ± 911.8 (1-2.5)23 (3)2No
Atallah et al[30], 20152.7 (1.5-3.5)225/75/0NoNo27 (15-39)33.3 (1-5)38 (6-12)3NoNo
Atallah et al[31], 20153100/0/0NoNo330.4
Huscher et al[32], 201585.7/14.3/0NoNo14 ± 312.7 ± 213.2 ± 1.812.5 (2–3.5)2
Kuo et al[33], 2017100/0/0NoNo12 (8-18)31.4 (0.4–3.5)30.7 (0.2-2.6)3
Hu et al[34], 20203.3 ± 1.5190/10/03 (15)No18.7 ± 6.312.9 ± 1.310.88 ± 0.7811 (5) 18 m 1 (5) 7
Monsellato et al[35], 2019100/0/0NoNo12 (12)NoNo
Tan et al[36], 20207NoNo
Suhardja et al[37], 2020100/0/0NoNo2412NoNoNo
Ye et al[38], 20213 (2–4)461.5/38.5/0NoNo15 (13-16)42 (1.5–2.5)415 (11–18)4NoNo