Robotic-assisted laparoscopic surgery of the colon and rectum: a literature review

Although it has been almost a decade since the implementation of robotic colorectal surgery, this modality remains under development. The aim of this study is to briefly describe, based on a literature review, the current role of robotic surgery of the colon and rectum. This emerging technique has revealed some benefits such as an improvement in visualization in 3D, image magnification up to 10 times the actual size, and better maneuverability with wrist-like movements offered by the da Vinci® Surgical System. This system is composed of the robotic console in which the surgeon performs the movements to be accomplished by the robot. The latter presents up to three articulated arms for instrumentation as well as the camera arm. Even though the safety and feasibility of robotic colon surgery has been demonstrated, there is no complete manifestation of the advantages of this technique due to the wide surgical field in the abdominal cavity and freedom of movement achieved with other minimally invasive techniques. Robotic rectal surgery represents a different scenario since the advantages of the da Vinci® system are maximally expressed in the confined pelvic cavity. Consequently, in some specialized centers, the robotic modality represents the first therapeutic choice for resectable rectal cancer. Robotic-assisted laparoscopy has demonstrated to be a feasible and safe approach in colorectal surgery and presents some advantages over other techniques in regards to perioperative outcomes. Nonetheless, costs and availability represent the main limitations of this technology.