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Chinese Journal of Colorectal Diseases(Electronic Edition) ›› 2026, Vol. 15 ›› Issue (04): 380-384. doi: 10.3877/cma.j.issn.2095-3224.2026.04.014

• Video • Previous Articles    

Snake-like robot-assisted transrectal NOTES small bowel resection and anastomosis: preliminary verification of procedural technical feasibility in a non-survival porcine model (with video)

Chenxi Hong1, Haoran Jin1, Yongpeng Wang2, Chundong Zhang3, Yun Qiao4, Rui Zhang1,†()   

  1. 1 Department of Colorectal Surgery, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, Shenyang 110042, China
    2 Department of Gynecology Surgery, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, Shenyang 110042, China
    3 Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China
    4 Department of Gastrointestinal Surgery,Changzhi People’s Hospital, Changzhi 046000,China
  • Received:2026-06-05 Online:2026-08-25 Published:2026-08-24
  • Contact: Rui Zhang

Abstract:

This article reports a case of small bowel resection and anastomosis performed via the transrectal NOTES approach using the Shurui® snake-like robotic system in a 30 kg healthy pig. After transrectal establishment of access to the peritoneal cavity, the robotic system was deployed to complete mesenteric vessel dissection, clipping, and transection, followed by bowel resection and hand-sewn full-thickness anastomosis. The specimen was retrieved transanally, and the rectal incision was closed per anally. The total operative time was 175 minutes, including 35 minutes for establishing the transrectal access and 140 minutes for robotic operation. Intraoperative blood loss was less than 10 mL, and no conversion to other approaches or intraoperative complications occurred. The animal was euthanized immediately after surgery. The findings demonstrate that the snake-like robotic system enables small bowel resection and anastomosis via the transrectal NOTES approach, with preliminary technical feasibility at the procedural execution level. However, clinical feasibility aspects such as anastomotic healing and infection control require further validation through survival studies.

Key words: Transrectal natural orifice transluminal endoscopic surgery, Snake-like Robot, Transrectal approach, Small bowel resection, Animal experiment

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