Natural orifice specimen extraction surgery (NOSES) can avoid additional abdominal incisions, improve cosmetic outcomes and have quick postoperative recovery. In our center, robotic anterior resection of rectal cancer without additional abdominal incision was performed innovatively using NOSES approach.

During October 2013 to December 2015, totally 19 patients undergoing this surgery were included into presented retrospective study. Patients′ clinicopathological characteristics, perioperative related outcomes, and follow-up outcomes were recorded.

All operations were carried out successfully. Patients recovered well after operation and discharged uneventfully. During the follow-up period, there is no serious abdominal and pelvic infections. No dysuria, sexual function disorder and fecal incontinence were found, and oncological outcomes were acceptable.

Taken together, robotic anterior resection of rectal cancer without abdominal incision is safe and feasible. Still, its long-term outcomes require increasing sample size and further investigation.