Robot-assisted rectal surgery for malignancy: a review of current literature

Laparoscopic colorectal surgery is rapidly gaining acceptance for the management of colorectal cancer. However, laparoscopic colorectal surgery is technically more challenging than conventional surgery. This challenge is more profound for laparoscopic rectal cancer, where there is a need to perform a total mesorectal excision (TME), in the confines of the pelvis, with the limitations of the laparoscopic system. The Da Vinci robotic surgical system was designed to overcome the pitfalls of laparoscopic surgery, hence the use of this novel system in colorectal surgery seems logical, in particular with regards to rectal cancer surgery. Recently, there have been an increasing number of reports in the literature on robotic colorectal surgery. The advantages of the robotic surgical system include; 7 degrees of movement, 3 dimensional views, tremor filtration, motion scaling and superior ergonomics. These advantages when applied to robotic TME for rectal cancer surgery may potentially translate to better outcomes. The aim of this review is to summarise the current evidence on clinical and oncological outcomes of robotic rectal cancer surgery.