Minimally invasive right colectomy: challenges and clinical practice.

Area of Science:

• Minimally Invasive Surgery
• Colorectal Surgery
• Surgical Technology

Background:

• Laparoscopic and robotic technologies are increasingly used in colorectal surgery.
• Right colectomy (RC) adoption of laparoscopy is widespread, but robotics and single-incision surgery present open questions.

Purpose of the Study:

• To review the literature on minimally invasive approaches to right colectomy (RC).
• To evaluate the risks, benefits, and costs of laparoscopic, robotic, and single-incision RC.
• To compare surgical outcomes, technical advantages, and oncological results.

Main Methods:

• A 20-year review of retrospective and prospective articles comparing open, laparoscopic, and robotic RC.
• Analysis of evidence for and against laparoscopy and robotics in intracorporeal vs. extracorporeal anastomosis, single-incision, and natural orifice surgery.

Main Results:

• Laparoscopic RC demonstrates reduced postoperative morbidity, faster bowel function recovery, and shorter hospital stays compared to open surgery, with similar oncological outcomes.
• Robotic RC is safe and feasible, but offers similar intraoperative and postoperative results to laparoscopy without clear advantages.
• Robotics can enhance single-incision and natural orifice surgery, enabling scarless procedures.

Conclusions:

• Laparoscopic right colectomy (RC) is a safe gold standard procedure when performed by trained surgeons.
• Robotic surgery for RC requires more multicenter randomized clinical trial evidence.
• Advancements in tools and instruments are needed to broaden the application of single-incision and natural orifice surgery.