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Updated: Feb 17, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Systematic review of robotic low anterior resection for rectal cancer
Christoph Holmer1, Martin E Kreis2
1Department of General, Visceral and Vascular Surgery, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany. christoph.holmer@charite.de.
Background:
Potential advantages of robotic surgery, such as 3-dimensional high-definition vision, wrist-like movements of instruments, stable camera holding, motion filter for tremor-free surgery, and improved ergonomics, may provide better clinical, oncological, and functional outcomes in rectal cancer surgery, as suggested in many comparative studies. However, there has not been a systematic review specific to LAR/TME for rectal cancer that includes both robotic versus laparoscopic and robotic versus open comparative studies.
Methods:
The PubMed and Scopus databases were systematically searched in a two-step process, first for all robotic publications, and then within those results, for studies that compared perioperative, oncologic, or functional outcomes of robotic versus laparoscopic or open LAR/TME. Randomized controlled trials, systematic reviews, and independent database population studies were included in the analysis.
Results:
Thirteen publications reporting on 24,526 patients met the inclusion criteria. Two studies compared robotic and open surgery, ten compared robotic and laparoscopic surgery, and one study compared all three. Robotic surgery resulted in increased operating times, reduced blood loss, fewer transfusions, shorter hospital stay, and comparable oncologic outcomes versus open surgery, and reduced conversion and impotency rates versus laparoscopic surgery.
Conclusions:
Robotic surgery is comparable to open and laparoscopic surgery concerning oncologic outcomes and seems to provide some clinical and functional benefits, although evidence is limited.
