Minimally Invasive Colorectal Surgery - Present and Future Trends

Area of Science:

• Minimally invasive surgery
• Surgical oncology
• Robotic surgery

Background:

• Surgical techniques have advanced, emphasizing minimally invasive approaches for better patient outcomes.
• Laparoscopic surgery is recommended for colon cancer but presents challenges for rectal cancer, including technical difficulty and suboptimal results.
• Robotic surgery has emerged as a potential solution to overcome laparoscopy's limitations in complex procedures.

Purpose of the Study:

• To compare the efficacy and applicability of laparoscopic versus robotic surgery in colorectal cancer treatment.
• To evaluate the benefits of robotic surgery in overcoming the limitations of laparoscopic rectal resection.
• To assess the potential impact of robotic surgery on functional outcomes and quality of life in rectal cancer patients.

Main Methods:

• Review of current guidelines and randomized control trials on laparoscopic colorectal surgery.
• Analysis of the technical advantages of robotic surgery over laparoscopy, focusing on visibility and instrument maneuverability.
• Comparison of indications for laparoscopic versus robotic approaches in colon and rectal cancers, considering patient factors like pelvic anatomy and BMI.

Main Results:

• Laparoscopic surgery is suitable for colon and superior rectal cancers.
• Robotic surgery is indicated for mid and lower rectal cancers, particularly in patients with narrow pelvis or high BMI, facilitating nerve preservation.
• Robotic approach enhances minimally invasive rectal resection, potentially improving functional outcomes and quality of life.

Conclusions:

• Robotic surgery offers significant advantages over laparoscopy for specific rectal cancer cases, improving the minimally invasive approach and nerve preservation.
• Despite its benefits, the high cost and limited availability of robotic systems pose challenges to its widespread adoption in colorectal cancer surgery.
• Further evaluation is needed to determine the long-term oncological and functional outcomes and the overall impact on the adoption rate of minimally invasive surgery in colorectal cancer treatment.