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The robotic platform provides an optimal view, an effective hemostasis during levator-sphincter dissection, and an efficient traction allowing meticulous pelvic dissections during ISR. The robotic platform was demonstrated to compensate for surgical difficulty when performing surgery on rectal cancer. The robotic platform, through the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA, USA), was intentionally developed to overcome the technical limitations of the laparoscopic approach by providing better ergonomics, eliminating physiologic tremors, adding an extra working arm, improving dexterity through articulated instruments with 7 degrees of freedom (EndoWrist Instruments, Intuitive Surgical, Inc.), and introducing a surgeon’s controlled magnified 3-dimensional stereoscopic stable camera. performed a retrospective comparative study between OISR and minimally invasive ISR (laparoscopic ISR, LISR robotic ISR, RISR) on a large series (n=313) of low rectal cancer demonstrating no difference in 5-year overall (OS) and disease-free survival (DFS).įew authors, especially from East Asian countries, have published studies on RISR. Minimally invasive approaches for ISR provide adequate perioperative, oncological, and functional results compared to open ISR (OISR). ISR requires a thorough knowledge of the deep pelvic anatomy, and careful patient selection after a critical evaluation of the indication criteria. ISR is a safe oncological alternative to abdominoperineal resection (APR) with the upturn of anus-preservation.

Intersphincteric resection (ISR) is the ultimate anus-preserving technique for the surgical treatment of low rectal cancer (within 5 cm from the anal verge, AV).

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