{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T19:22:16Z","timestamp":1780341736198,"version":"3.54.1"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Colon Rectal Surg"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In recent decades, surgery for rectal cancer has evolved from an operation normally performed under poor vision with a lot of blood loss, relatively high morbidity, and mortality to a safer operation. Currently, minimally invasive rectal procedures are performed with limited blood loss, reduced morbidity, and minimal mortality. The main cause is better knowledge of anatomy and adhering to the principle of operating along embryological planes. Surgery has become surgery of compartments, more so than that of organs. So, rectal cancer surgery has evolved to mesorectal cancer surgery as propagated by Heald and others. The focus on the mesentery of the rectum has led to renewed attention to the anatomy of the fascia surrounding the rectum. Better magnification during laparoscopy and improved optimal three-dimensional (3D) vision during robot-assisted surgery have contributed to the refinement of total mesorectal excision (TME). In this chapter, we describe how to perform a robot-assisted TME with particular attention to the mesentery. Specific points of focus and problem solving are discussed.<\/jats:p>","DOI":"10.1055\/s-0042-1743583","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T22:30:15Z","timestamp":1660170615000},"page":"298-305","source":"Crossref","is-referenced-by-count":4,"title":["The Mesentery in Robot-Assisted Total Mesorectal Excision"],"prefix":"10.1055","volume":"35","author":[{"given":"Rogier M.P.H.","family":"Crolla","sequence":"additional","affiliation":[{"name":"Department of Surgery, Laparoscopic and Robotic Gastrointestinal\/Oncological Surgeon, Amphia Hospital, Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Calvin","family":"Coffey","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospitals Group Limerick, Limerick, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther J. C.","family":"Consten","sequence":"additional","affiliation":[{"name":"Department of Surgery, Laparoscopic and Robotic Gastrointestinal\/Oncological Surgeon, Academic Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1097\/SLA.0000000000000323","article-title":"The mesocolon: a histological and electron microscopic characterization of the mesenteric attachment of the colon prior to and after surgical mobilization","volume":"260","author":"K Culligan","year":"2014","journal-title":"Ann Surg"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/S2468-1253(16)30026-7","article-title":"The mesentery: structure, function, and role in disease","volume":"1","author":"J C Coffey","year":"2016","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10350-004-6104-5","article-title":"Mobilization of the rectum: anatomic concepts and the bookshelf revisited","volume":"45","author":"P Chapuis","year":"2002","journal-title":"Dis Colon Rectum"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1177\/014107688808100904","article-title":"The 'Holy Plane' of rectal surgery","volume":"81","author":"R J Heald","year":"1988","journal-title":"J R Soc Med"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1002\/(SICI)1098-2388(199809)15:2<66::AID-SSU2>3.0.CO;2-3","article-title":"Embryology and anatomy of the rectum","volume":"15","author":"R J Heald","year":"1998","journal-title":"Semin Surg Oncol"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1053\/j.scrs.2010.01.006","article-title":"Topology of the fascial structures in rectal surgery: complete cancer resection and the importance of avoiding autonomic nerve injury","volume":"21","author":"Y Kinugasa","year":"2010","journal-title":"Semin Colon Rectal Surg"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1002\/bjs.5540","article-title":"Histological identification of fascial structures posterolateral to the rectum","volume":"94","author":"Y Kinugasa","year":"2007","journal-title":"Br J Surg"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1111\/codi.14502","article-title":"European consensus on the standardization of robotic total mesorectal excision for rectal cancer","volume":"21","author":"D Miskovic","year":"2019","journal-title":"Colorectal Dis"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"2533","DOI":"10.7314\/APJCP.2014.15.6.2533","article-title":"New insights into autonomic nerve preservation in high ligation of the inferior mesenteric artery in laparoscopic surgery for colorectal cancer","volume":"15","author":"X F Yang","year":"2014","journal-title":"Asian Pac J Cancer Prev"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1007\/s00464-010-1284-7","article-title":"Laparoscopic lymph node dissection around the inferior mesenteric artery with preservation of the left colic artery","volume":"25","author":"M Sekimoto","year":"2011","journal-title":"Surg Endosc"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"O206","DOI":"10.1111\/codi.13299","article-title":"Apical lymph node dissection of the inferior mesenteric artery","volume":"18","author":"N Goh","year":"2016","journal-title":"Colorectal Dis"},{"issue":"43","key":"ref12","doi-asserted-by":"crossref","first-page":"5411","DOI":"10.3748\/wjg.v16.i43.5411","article-title":"Anatomy of the lateral ligaments of the rectum: a controversial point of view","volume":"16","author":"G J Wang","year":"2010","journal-title":"World J Gastroenterol"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3349\/ymj.2021.62.3.187","article-title":"Optimal complete rectum mobilization focused on the anatomy of the pelvic fascia and autonomic nerves: 30 years of experience at Severance Hospital","volume":"62","author":"N K Kim","year":"2021","journal-title":"Yonsei Med J"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/00000658-198810000-00001","article-title":"Radical pelvic surgery with preservation of sexual function","volume":"208","author":"P C Walsh","year":"1988","journal-title":"Ann Surg"},{"issue":"07","key":"ref15","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1007\/s10350-006-0557-7","article-title":"Operating behind Denonvilliers' fascia for reliable preservation of urogenital autonomic nerves in total mesorectal excision: a histologic study using cadaveric specimens, including a surgical experiment using fresh cadaveric models","volume":"49","author":"Y Kinugasa","year":"2006","journal-title":"Dis Colon Rectum"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s10350-004-0627-7","article-title":"Denonvilliers' fascia lies anterior to the fascia propria and rectal dissection plane in total mesorectal excision","volume":"48","author":"I Lindsey","year":"2005","journal-title":"Dis Colon Rectum"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"e473","DOI":"10.1097\/SLA.0000000000004591","article-title":"Effect of Denonvilliers' fascia preservation versus resection during laparoscopic total mesorectal excision on postoperative urogenital function of male rectal cancer patients: initial results of Chinese PUF-01 randomized clinical trial","volume":"274","author":"B Wei","year":"2020","journal-title":"Ann Surg"},{"issue":"11","key":"ref18","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1111\/codi.15084","article-title":"Robotic vs laparoscopic total mesorectal excision for rectal cancers: has a paradigm change occurred? A systematic review by updated meta-analysis","volume":"22","author":"P Gavriilidis","year":"2020","journal-title":"Colorectal Dis"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s10151-018-1920-0","article-title":"Laparoscopic vs. robotic rectal cancer surgery and the effect on conversion rates: a meta-analysis of randomized controlled trials and propensity-score-matched studies","volume":"23","author":"K Phan","year":"2019","journal-title":"Tech Coloproctol"}],"container-title":["Clinics in Colon and Rectal Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1743583.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T22:33:07Z","timestamp":1660516387000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1743583"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":19,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2022,8,10]]},"published-print":{"date-parts":[[2022,7]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1743583","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1531-0043","1530-9681"],"issn-type":[{"value":"1531-0043","type":"print"},{"value":"1530-9681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]}}}