[Robotic Colorectal Surgery in Israel - An Institutional Learning Curve and a Glance to the Future]

During the last decade, the use of the robotic platform (the De Vinci system) for colorectal surgery, especially in rectal resection in the pelvis, has gained increasing popularity. In Israel, and particularly in the field of general surgery, the use of the robot is still in its beginning. In this article we present our personal institutional experience in robotic colorectal surgeries, our surgical outcomes and departmental learning process.

The retrospective research was based on the collection of data from all patients who underwent robotic colorectal surgeries in a two-year period (from January 2023 until February 2025). The data was collected from surgical reports and medical information with the approval of the institutional Helsinki committee.

During the study period, 41 robotic colorectal surgeries were conducted, most of which (30 out of 41) were with an oncologic indication. Among the major complications were two (4.8%) cases of anastomotic leaks requiring re-operation, one patient re-operated due to bowel ischemia and one case of a thermic side injury of the left ureter treated with ureteral stent. No mortality was reported during this period. In addition, we demonstrate a gradual and consistent shortening of operating time in right hemicolectomy and sigmoidectomy.

During the two years in which the robotic approach for colorectal surgeries has been applied in our department, we showed that by maintaining an ordered learning process, choosing the appropriate cases and with the assistance of good guidance, we were able to achieve good surgical results without increasing the complication rate.