Robotic Total Mesorectal Excision for Rectal Cancer: Current Evidences and Future Perspectives

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Procedures

Background:

• Laparoscopic total mesorectal excision (LTME) for rectal cancer presents short-term benefits but controversial pathological outcomes.
• Robotic total mesorectal excision (RTME) is emerging as a potentially superior minimally invasive approach.

Purpose of the Study:

• To compare the outcomes of robotic total mesorectal excision (RTME) with laparoscopic total mesorectal excision (LTME) for rectal cancer.
• To evaluate the technical feasibility, functional results, and potential oncological benefits of RTME.

Main Methods:

• Comparative analysis of randomized clinical trials and observational studies.
• Assessment of conversion rates, genitourinary function, operating time, and learning curves.
• Evaluation of suitability for specific patient populations, such as males with narrow deep pelvises.

Main Results:

• RTME demonstrates lower conversion rates and comparable or improved genitourinary function compared to LTME.
• RTME has a shorter learning curve and is more surgeon-convenient, potentially offering better sphincter preservation.
• Long-term oncological outcomes for RTME are still under investigation.

Conclusions:

• Robotic surgical systems are valuable tools for minimally invasive rectal cancer surgery, particularly in challenging anatomies.
• RTME shows significant advantages in terms of technical execution and functional outcomes over LTME.
• Continued advancements in robotic technology are expected to enhance the role of RTME in rectal cancer treatment.