Study on Effect of Robotic Versus Laparoscopic Surgical Technology on Genitourinary Function After Total Mesorectal Excision for Rectal Cancer

International Prostate Symptom Score (IPSS)

Intraoperative pelvic autonomic nerve (PAN) injury is the dominant reason for genitourinary
 malfunction after total mesorectal excision (TME), particularly in low rectal tumours. TME
 necessitates meticulous, sharp dissection with an awareness of the PAN pathway. In
 particular, laparoscopic TME (L-TME) is technically difficult and requires advanced
 laparoscopic surgical skills. Comparing with the conventional laparoscopic approach, 3D
 vision, surgeon-manipulated camera systems, and multi-degree-of-freedom robotic instruments
 facilitate identification and preservation of the PAN during robotic-assisted TME (R-TME),
 theoretically facilitating favourable recovery of postoperative genitourinary function.
 Previous studies have mostly focused on the impact of advanced robotic technologies on
 postoperative functions. However, in addition to robotic surgical technology, postoperative
 function is impacted by multiple other intricate factors, such as oncology, comorbidities,
 postoperative complications, and adjuvant chemoradiotherapy. Consequently, the superiority of
 robotic surgery in terms of recovery of postoperative genitourinary function has been
 controversial in previous studies. Hence, to comprehensively evaluate the effect of robotic
 technology on postoperative genitourinary function, we conducted a prospective controlled
 study comparing the conventional approach and robotic surgery.