{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:29:20Z","timestamp":1788316160691,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Total neoadjuvant therapy (TNT) for locally advanced rectal cancer (LARC) is rapidly spreading. The robotic surgical techniques to approach lateral invasion, such as that of the pelvic plexus, have not yet been established. In this technical note, we present a video illustrating a surgical technique for lateral invasion using our novel technique and discuss its pitfalls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We present the case of a 65\u2010year\u2010old man with LARC. Robotic surgery was performed after TNT using the da Vinci Xi Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA). The surgical procedure was as follows: (1) D3 lymph node dissection around the inferior mesenteric artery using a medial\u2010to\u2010lateral approach; (2) rectal mobilization; (3) dissection of the ureterohypogastric fascia and ureter; and (4) combined resection of the hypogastric nerve and pelvic plexus. The key surgical point for sidewall invasion is the resection extent. Dividing the resection extent into three areas is important: zone A, which contains the pelvic plexus and is closest to the tumour; zone B, which contains the iliac vessels; and zone C, the most lateral zone, which contains the obturator nerves. This allows organ and function preservation by resecting only the smallest organ that truly requires R0 resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The operating time was 333\u2009min, console time was 232\u2009min, and blood loss was 0\u2009mL. The circumferential resection margin was 10\u2009mm, and an R0 resection was achieved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We introduced a novel approach for robotic surgery after TNT for LARC with sidewall invasion. This technique can be performed safely and may help standardize \u2018beyond total mesorectal excision\u2019.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16969","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T04:57:45Z","timestamp":1712120265000},"page":"1047-1052","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Robotic surgery after total neoadjuvant therapy for rectal cancer: pitfalls of beyond total mesorectal excision for patients with sidewall invasion"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3049-0904","authenticated-orcid":false,"given":"Kenta","family":"Iguchi","sequence":"first","affiliation":[{"name":"Department of Surgery, Gastroenterological Center Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakatsu","family":"Numata","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastroenterological Center Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Atsumi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastroenterological Center Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastroenterological Center Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Rino","sequence":"additional","affiliation":[{"name":"Department of Surgery Yokohama City University  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Surgery Yokohama City University  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01667"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(21)00079\u20106"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01208"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/CANCERS14133204"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/CODI.16854"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010023\u201004376\u2010y"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ONCO.13824"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010018\u20101883\u20101"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010007\u20109385\u20109"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0B013E31827A7868"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.EJSO.2021.12.472"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2021.05.017"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAONCOL.2018.0071"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.0070"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.16969","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T04:48:45Z","timestamp":1716612525000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.16969"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,2]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/codi.16969"],"URL":"https:\/\/doi.org\/10.1111\/codi.16969","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,2]]},"assertion":[{"value":"2024-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}