Minimally invasive laparoscopic low or ultra-low anterior resection may present as a complex, technically difficult challenge to even the most experienced of colorectal surgeons. This is because, within the narrow confines of the pelvis, there is usually limited visibility, and difficult manoeuvrability of rigid laparoscopic instrumentation with resulting poor access. The utilisation of robotic technology makes sense within the narrow confines of the pelvis. Several studies including recent meta-analyses of randomized controlled trials and propensity-score-matched cohorts have shown reduced rates of conversion to open. Some studies have also shown benefits including improved short-term outcomes and oncological benefits. However, robotic ultra-low anterior resection has a steep learning curve and many of the benefits of robotic surgery have not been fully realised, because the majority of surgeons are in the early phase of the learning curve. This 'How I do It' article provides a detailed description of the important technical points that may help in maximising success in performing robotically assisted laparoscopic ultra-low anterior resection.

中文翻译：

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机器人低位前切除术：如何在困难的手术中获得最大的成功。

即使对于最有经验的结直肠外科医师而言，微创腹腔镜低位或超低位前切除术也可能是一项复杂的，技术上困难的挑战。这是因为，在骨盆的狭窄范围内，通常可见度有限，并且刚性腹腔镜器械的机动性较差，从而导致难以接近。在骨盆狭窄的范围内，利用机器人技术是有意义的。包括最近的随机对照试验的荟萃分析和倾向得分匹配的队列在内的几项研究表明，转化为开放型的比率降低。一些研究还显示了益处，包括改善的短期结果和肿瘤学益处。然而，机器人超低位前切除术具有陡峭的学习曲线，并且由于大多数外科医生都处于学习曲线的早期阶段，因此尚未充分实现机器人手术的许多好处。这篇“我该怎么做”的文章详细介绍了重要的技术要点，这些技术要点可能有助于最大程度地成功执行机器人辅助的腹腔镜超低位前切除术。