Total Mesorectal Excision with New Robotic Platforms: A Scoping Review

Area of Science:

• Surgical Robotics
• Colorectal Surgery
• Oncology

Background:

• Robotic technology has transformed colorectal surgery, with the Da Vinci system dominating rectal resections for over two decades.
• Emerging robotic platforms now offer alternatives for total mesorectal excision (TME), a critical procedure for rectal cancer.

Purpose of the Study:

• To evaluate the role and adoption of novel robotic systems in performing TME for rectal cancer.
• To synthesize current evidence on the feasibility, safety, and outcomes of TME using alternative robotic platforms.

Main Methods:

• A comprehensive scoping review following PRISMA-ScR guidelines.
• Systematic literature search of Medline, Embase, and Cochrane databases up to August 2024.
• Inclusion of 36 studies detailing TME procedures using various robotic platforms.

Main Results:

• Eight different robotic platforms were utilized across the included studies.
• Intraoperative, short-term, and functional outcomes were generally favorable.
• Pathological results, particularly specimen quality, were frequently incomplete, and limited advanced instrumentation was noted.

Conclusions:

• Total mesorectal excision (TME) using emerging robotic platforms is feasible and safe for rectal cancer surgery.
• The current evidence base is limited, especially concerning pathological assessment and long-term survival outcomes.
• Further research is crucial to fully understand the benefits and limitations of these new robotic systems in rectal cancer treatment.