Lower Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures.

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Minimally invasive surgery in lower GI procedures faced challenges due to complexity.
• Robotic operating platforms and transanal total mesorectal excision (taTME) have transformed minimally invasive approaches.
• Advancements aim to improve perioperative outcomes and oncological resection quality.

Purpose of the Study:

• To review the current state of robotic surgery (RS) and taTME in lower GI surgery.
• To evaluate the advantages and disadvantages of these techniques.
• To assess their impact on perioperative outcomes and oncological resection.

Main Methods:

• Systematic literature search for studies on robotic surgery (RS) versus laparoscopic surgery (LS).
• Keywords included 'colorectal cancer', 'rectal cancer', 'minimally invasive surgery', 'laparoscopic surgery', and 'robotic'.
• Publications on taTME were analyzed separately.

Main Results:

• 69 studies on RS involving 20,872 patients were identified.
• 17 articles on taTME, including 881 patients, were analyzed.
• Both RS and taTME are increasingly applicable to lower GI surgery.

Conclusions:

• Robotic surgery and taTME enhance minimally invasive options for lower GI surgery.
• Combining RS and taTME may offer benefits for select patients.
• Further prospective, randomized trials are necessary to validate benefits over conventional laparoscopic approaches.