Minimally Invasive Surgery for Rectal Cancer

This chapter will touch on the brief history of MIS for rectal cancer. The major preoperative considerations including setup and port placement will follow. In-depth descriptions and depictions of three main operations will be given for both laparoscopic and robotic approaches, using the traditional 2D laparoscopic and the main Intuitive robotic models in use today (da Vinci Xi platform). This includes the low anterior resection (LAR), low anterior resection with coloanal anastomosis or the so-called ultralow LAR (ULAR), and finally the abdominoperineal resection (APR). Major postoperative considerations will be discussed including the most prominent complications and their management. Finally, we will outline the authors’ own experiences with these procedures and provide a perspective of future developments. As several new robotic and hybrid laparoscopic platforms are entering the surgery market, their specific place will yet have to be defined. But unquestionably, this same chapter will probably look very different a decade from now in terms of options.