Dealing with robot-assisted surgery for rectal cancer: Current status and perspectives

World J Gastroenterol. 2016 Jan 14;22(2):546-56. doi: 10.3748/wjg.v22.i2.546.

Abstract

The laparoscopic approach for treatment of rectal cancer has been proven feasible and oncologically safe, and is able to offer better short-term outcomes than traditional open procedures, mainly in terms of reduced length of hospital stay and time to return to working activity. In spite of this, the laparoscopic technique is usually practised only in high-volume experienced centres, mainly because it requires a prolonged and demanding learning curve. It has been estimated that over 50 operations are required for an experienced colorectal surgeon to achieve proficiency with this technique. Robotic surgery enables the surgeon to perform minimally invasive operations with better vision and more intuitive and precise control of the operating instruments, thus promising to overcome some of the technical difficulties associated with standard laparoscopy. It has high-definition three-dimensional vision, it translates the surgeon's hand movements into precise movements of the instruments inside the patient, the camera is held and moved by the first surgeon, and a fourth robotic arm is available as a fixed retractor. The aim of this review is to summarise the current data on clinical and oncologic outcomes of robot-assisted surgery in rectal cancer, focusing on short- and long-term results, and providing original data from the authors' centre.

Keywords: Circumferential resection margin; Distal resection margin positivity; Lymph node yield; Rectal cancer; Robotic resection; Robotic surgery; Robotic total mesorectal excision.

Publication types

  • Review

MeSH terms

  • Clinical Competence
  • Cost-Benefit Analysis
  • Digestive System Surgical Procedures / adverse effects
  • Digestive System Surgical Procedures / economics
  • Digestive System Surgical Procedures / methods*
  • Health Care Costs
  • Humans
  • Learning Curve
  • Postoperative Complications / etiology
  • Psychomotor Performance
  • Rectal Neoplasms / economics
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery*
  • Robotic Surgical Procedures* / adverse effects
  • Robotic Surgical Procedures* / economics
  • Time Factors
  • Treatment Outcome