Robotic Surgery for Colon and Rectal Cancer: Current Status, Recent Advances, and Future Directions

AbstractPurpose of ReviewThe minimally invasive approach to colorectal cancers has been validated as providing oncologic outcomes comparable to open surgery. Current laparoscopic instrumentation, however, has its limitations especially in the performance of rectal cancer resections. Robotic surgery for colorectal cancers is an important addition to the technologies available to the surgeon. We review the literature and draw on our own experience to examine the advantages and disadvantages of robot-assisted surgery for the treatment of colorectal cancers and the evidence for the superior outcomes frequently cited and to identify subsets that may benefit the most.Recent FindingsMost of the evidence for robotic surgery emanates from nonrandomized studies. These studies show acceptable perioperative and oncologic outcomes, with lower conversion rates and circumferential margin positivity than with laparoscopy. The only randomized trial, the ROLARR, did not show any significant difference between the two modalities regarding conversion rates or pathologic outcomes.SummaryCurrent evidence does not conclusively support robotic surgery over laparoscopy or vice versa. Robotics is an emerging field and innovations including the current da Vinci Xi system, single port, and TAMIS platforms may all enable more complex surgeries going forward. Robotic surgery has a short learning curve. Patients undergoing surgery for low rectal cancers, who have any combination of male gender, obesity, an...
Source: Current Colorectal Cancer Reports - Category: Cancer & Oncology Source Type: research