Surgical Outcomes of Low Anterior Resection Using the Senhance Surgical System: A Single‐Center Case Series

Abstract

INTRODUCTION: The Senhance Surgical System is the second robotic surgical platform approved for laparoscopic procedures in Japan. It is unique compared to other systems, offering eye-tracking camera control, haptic feedback, and reusable instruments. Although its application in colon surgery has shown favorable outcomes, reports on its utility in rectal cancer surgery are limited. We aimed to evaluate the surgical outcomes of patients who underwent Senhance-assisted low anterior resection for rectal cancer. MATERIALS AND SURGICAL TECHNIQUE: We retrospectively analyzed 16 patients who underwent low anterior resection for rectal cancer using the Senhance system between February 2020 and December 2022. Surgical indications included resectable rectal cancer without adjacent organ invasion or emergency presentation. Demographic data, perioperative outcomes, pathological findings, and recurrence were assessed. The median duration of the operation was 308.5 min, with minimal blood loss (median 0 mL). Conversion to laparoscopy occurred in 5 patients (31.3%) due to pelvic dissection difficulty. There was no case of conversion to open surgery. No Clavien-Dindo grade ≥ 2 complications were observed. The median duration of hospitalization was 8 (6-14) days. R0 resection was achieved in 14 cases, and R2 resection was performed in 2 cases with synchronous distant metastases. The median number of harvested lymph nodes was 22. Four patients (28.6%) experienced recurrence, excluding those with stage IV disease. DISCUSSION: Senhance-assisted low anterior resection can be safely performed with acceptable short-term oncological outcomes. However, its limitations in deep pelvic dissection and system setup require further investigation. Larger studies are needed to validate its utility in rectal surgery.