Single-port Robotic Transanal Total Mesorectal Excision in a Porcine Model (Sus scrofa domesticus)

This study presents a step-by-step protocol by using a robotic system for performing SP robotic transanal total mesorectal excision (taTME) in a porcine model. The goal is to evaluate the feasibility, procedural characteristics, and immediate postoperative outcomes of this novel approach. Compared to conventional laparoscopic and robotic systems, this technique offers potential advantages in maneuverability and visualization within the narrow pelvic space. This protocol involves sequential abdominal and transanal phases, providing clear guidance for surgical preparation, robotic docking, dissection, specimen retrieval, and anastomosis. The study includes ethical considerations and detailed intraoperative management to ensure reproducibility. Representative results demonstrate successful rectal resection without intraoperative complications. The total operative time was 140 min, including 25 min for robotic docking, 45 min for the abdominal phase, 35 min for transanal dissection, and 35 min for anastomosis and closure. Estimated blood loss was approximately 10 mL. This protocol utilized the SHURUI SP robotic system, with a dual-continuum snake-like arm design offering enhanced dexterity and instrument control in confined anatomical spaces. The described method establishes a standardized and reproducible preclinical framework, serving as a valuable platform for technical training, advanced device testing, and the refinement of SP robotic taTME protocols prior to clinical translation.