Early Clinical Outcomes of Robotic Intracorporeal Single-Stapled Anastomosis (RiSSA) in Total Mesorectal Excision for Rectal Cancer

Robotic intracorporeal single-stapled anastomosis (RiSSA) is an innovative technique in robotic low anterior resection with total mesorectal excision (LAR-TME), though its outcomes remain underreported, particularly among Asian rectal cancer patients. This study retrospectively evaluated early clinical outcomes of RiSSA in robotic LAR-TME performed at a tertiary medical center in Kaohsiung, Taiwan. A total of 22 rectal cancer patients undergoing robotic LAR-TME with RiSSA between May 2023 and September 2024 were reviewed. Demographic and tumor-related factors such as age, gender, BMI, tumor size, and location were analyzed, along with key surgical and postoperative outcomes including blood loss, operative time, complications, mortality, length of hospital stay, ICU admissions, readmissions, and reoperations. The median patient age was 60.4 years. 72.7% of the patients were male. Median BMI and tumor size were 23.0 kg/m² and 3.6 cm, respectively. 68.2% of the tumors were in the mid or lower rectum. The median console time was 186.5 minutes. The median intraoperative estimated blood loss was 40 mL. No mortality or anastomotic leakage occurred. The median hospital stay was 7 days, with only three minor complications (Clavien-Dindo I-II) reported, including wound infections and chyle leakage. No unplanned ICU admissions, readmissions, or reoperations occurred. These findings suggest that RiSSA during robotic LAR-TME is a safe and feasible alternative to conventional double-stapled anastomosis methods, demonstrating favorable short-term outcomes with minimal complications. Further large-scale studies are warranted to validate its long-term safety and clinical effectiveness.