Precision Robotic Surgery: Scarless NOSES Resection for Colorectal Cancer
Precision Robotic Surgery: Scarless NOSES Resection for Colorectal Cancer
——Advantages in Lateral Pelvic Lymph Node Dissection and Autonomic Nerve Preservation
In February 2023, the Department of Gastrointestinal Surgery at Wuwei Cancer Hospital became the first municipal hospital in Gansu Province to perform radical gastrectomy and colorectal cancer resection using surgical robots. In March 2023, we achieved another milestone by completing China's first domestically produced Tuomai robotic radical resection for rectal cancer with scarless specimen extraction via natural orifice (NOSES), marking the inaugural case of robotic NOSES for rectal cancer in China.
On May 13, 2024, our Department of Gastrointestinal Surgery successfully hosted a training workshop on robotic radical NOSES for rectal cancer with lateral lymph node dissection. Director Chen Hongbing demonstrated operational techniques for robotic radical resection of rectal cancer combined with lateral lymph node dissection; Director Ma Youguo shared indications and treatment protocols for radiotherapy in rectal cancer patients; Director Zhao Zhiping analyzed MRI-based diagnosis and staging of rectal cancer; Director Li Shihua elaborated on endoscopic treatment strategies for early-stage rectal cancer.
The workshop attracted 12 attending physicians and key staff members from Jinchang People's Hospital, Gulang County Hospital, Gulang County Traditional Chinese Medicine Hospital, Tianzhu Tibetan Hospital, Tianzhu County Hospital, and Minqin County Hospital. After theoretical sessions, participants conducted hands-on observation of robotic surgical procedures in the operating room, where they experienced firsthand the advanced capabilities of the robotic system—including ultra-high-definition 3D naked-eye imaging, exquisite surgical dexterity, precise anatomical dissection, lateral lymph node dissection, and nerve preservation techniques. Experts unanimously praised the robotic system's high-tech artificial intelligence advantages, hailing it as "minimally invasive within minimally invasive surgery" and the "future direction of surgical innovation".
Robotic NOSES surgery demonstrates significant clinical advantages, including reduced surgical trauma, increased lymph node harvest, superior anal sphincter preservation rates (enabling sphincter-saving surgery for nearly all ultra-low rectal cancers), and accelerated postoperative recovery. These benefits highlight the distinct advantages of robotic surgical systems:
- 10-15x magnification with three-dimensional ultra-high-definition (UHD) naked-eye imaging, providing exceptional anatomical clarity and precision in dissection.
- Minimal intraoperative blood loss and significantly reduced complication rates.
- 7-degrees-of-freedom robotic arms with 540° articulation, enabling unparalleled access to complex anatomical regions and eliminating surgical blind spots.
- Advanced tremor filtration system that eliminates physiological hand tremors through real-time motion scaling and precise instrument control.
- Ergonomic console operation allowing surgeons to perform procedures in a comfortable seated position, substantially reducing fatigue during extended surgeries.
- As the future paradigm of minimally invasive surgery, domestically developed robotic systems—offering exceptional cost-effectiveness—will emerge as the dominant choice for surgical procedures.
Director Chen Hongbing's team successfully completed a robotic radical NOSES surgery for low rectal cancer with lateral lymph node dissection. Following the conference, Director Chen personally presented robotic surgery training certificates to the participants.