{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:28:12Z","timestamp":1793316492002,"version":"4.5.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:00:00Z","timestamp":1725494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:00:00Z","timestamp":1725494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Robotic three-dimensional magnified visual effects and field of view stabilization have enabled precise surgical operations. Intracorporeal anastomosis in right-sided colorectal cancer surgery is expected to shorten operation times, avoid paralytic ileus, and shorten wound lengths; however, there are few reports of intracorporeal anvil fixation for intestinal anastomosis in left-sided colorectal cancer surgery. Herein, we introduce a simple, novel procedure for using robotic purse-string suture (RPSS) in intracorporeal anastomosis with the double-stapling technique in rectal and sigmoid cancer surgery and report short-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From September 2022 to April 2024, 105 consecutive patients underwent robotic surgery with double-stapling technique anastomosis for rectal or sigmoid colon cancer at our institution. Their data were retrospectively analyzed. Intracorporeal anastomosis with the double-stapling technique using RPSS was performed in 26 patients (the RPSS group), while the double-stapling technique anastomosis with extracorporeal anvil fixation was performed in 79 patients (the EC group). A 1:1 propensity score-matched analysis was performed (matching criteria: sex, age, body mass index (BMI), tumor location and tumor size) using a caliper 0.3.<\/jats:p>\n                    <jats:p>In the RPSS group, after tumor-specific or total mesorectal excision, specimens were extracted from the umbilical wound with simultaneous anvil placement in the body cavity. The oral colonic stump was robotically excised and robotically circumferentially stitched with 3\u20130 Prolene in all layers. After anvil insertion into the stump, the bowel wall of the colon was completely sewn onto the central rod of the anvil. Reconstructions were anastomosed using the double-stapling technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The matched cohort contained 23 patients in each group. The RPSS group had significantly less bleeding than the EC group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038). Super-low anterior resection (SLAR) in the RPSS group had shorter total operative times than those in the EC group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). The RPSS group experienced no perioperative complications greater than Clavien\u2013Dindo grade III or any anastomosis-related complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The RPSS technique can be performed safely without any anastomosis-related complications and reduces the total operative times in SLAR and blood loss through total robotic surgery. This may be a useful modality for robotic colorectal surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-024-02551-8","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T03:03:13Z","timestamp":1725505393000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Robotic purse-string suture technique for intracorporeal anastomosis using double-stapling technique in robotic resection of rectal and sigmoid colon cancer: a propensity score-matched analysis"],"prefix":"10.1186","volume":"24","author":[{"given":"Masayuki","family":"Hiraki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiminori","family":"Yanagisawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Ikeshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taishi","family":"Hata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumasa","family":"Komura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asami","family":"Arita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinsuke","family":"Katsuyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go","family":"Shinke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Kinoshita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Ohmura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keijiro","family":"Sugimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Masuzawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Murata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,5]]},"reference":[{"key":"2551_CR1","doi-asserted-by":"publisher","first-page":"1886","DOI":"10.1007\/s00464-009-0865-9","volume":"24","author":"J Grams","year":"2010","unstructured":"Grams J, Tong W, Greenstein AJ, Salky B. Comparison of intracorporeal versus extracorporeal anastomosis in laparoscopic-assisted hemicolectomy. Surg Endosc. 2010;24:1886\u201391. https:\/\/doi.org\/10.1007\/s00464-009-0865-9.","journal-title":"Surg Endosc"},{"key":"2551_CR2","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1002\/bjs.11519","volume":"107","author":"SH Emile","year":"2020","unstructured":"Emile SH. Intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy; earlier recovery, less complications, and more. Br J Surg. 2020;107:614. https:\/\/doi.org\/10.1002\/bjs.11519.","journal-title":"Br J Surg"},{"key":"2551_CR3","first-page":"229","volume":"93","author":"D Provenzano","year":"2022","unstructured":"Provenzano D, Lo Bianco S, Zangh\u00ec G, Griggio G, Sardo F, Morici R, et al. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy A retrospective study and review of literature. Ann Ital Chir. 2022;93:229\u201334.","journal-title":"Ann Ital Chir"},{"key":"2551_CR4","doi-asserted-by":"publisher","first-page":"2831","DOI":"10.1177\/00031348211023417","volume":"88","author":"M Ishizuka","year":"2022","unstructured":"Ishizuka M, Shibuya N, Takagi K, Hachiya H, Tago K, Shimizu T, et al. Postoperative complications associated with intra- versus extracorporeal anastomosis for laparoscopic right colectomy. Am Surg. 2022;88:2831\u201341. https:\/\/doi.org\/10.1177\/00031348211023417.","journal-title":"Am Surg"},{"key":"2551_CR5","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s11701-017-0759-0","volume":"12","author":"SR Kelley","year":"2018","unstructured":"Kelley SR, Duchalais E, Larson DW. Robotic right colectomy with intracorporeal anastomosis for malignancy. 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Surg Endosc. 2022;36:3645\u201352. https:\/\/doi.org\/10.1007\/s00464-022-09048-6.","journal-title":"Surg Endosc"},{"key":"2551_CR8","doi-asserted-by":"publisher","first-page":"290","DOI":"10.5230\/jgc.2019.19.e26","volume":"19","author":"Y Takayama","year":"2019","unstructured":"Takayama Y, Kaneoka Y, Maeda A, Fukami Y, Takahashi T, Uji M. A Novel Technique of Hand-Sewn Purse-String Suturing by Double Ligation Method (DLM) for Intracorporeal Circular Esophagojejunostomy. J Gastric Cancer. 2019;19:290\u2013300. https:\/\/doi.org\/10.5230\/jgc.2019.19.e26.","journal-title":"J Gastric Cancer"},{"key":"2551_CR9","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/s12893-024-02423-1","volume":"24","author":"L Sun","year":"2024","unstructured":"Sun L, Wang W, Zhou J, Ji L, Zhao S, Fu A, et al. Modified Q-type purse-string suture duodenal stump embedding method for laparoscopic gastrectomy for gastric cancer. 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A meta-analysis of robotic versus laparoscopic colectomy. 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This study was approved by Institutional Review Board (IRB) committee of Kansai Rosai Hospital (the approval number 2301002).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"249"}}