Global Evolution of Robotic Colorectal Surgery: Lessons from Hong Kong's Innovation and Implementation

Robotic colorectal surgery has revolutionized minimally invasive techniques worldwide, offering a more stable operative platform, superior 3D visualization, and wristed instrumentation for challenging pelvic dissections. This narrative review describes the global evolution of robotic colorectal surgery, from the use of multi-port to single-port systems, modular platforms and endoluminal robotic devices. Using Hong Kong's role as an innovation and research hub, this review demonstrates how integrated innovation, structured training, workflow efficiencies and digital policy frameworks can overcome barriers and inform international implementation of robotic colorectal surgery. Since 2005, The Chinese University of Hong Kong has been pioneering the use of robotic platforms in colorectal surgery, performing first-in-human trials of the da Vinci SP system, the locally developed Sentire C1000 and the EndoMaster EASE for robotic ESD. There is increasing evidence supporting the use of the robotic platform over laparoscopic colorectal surgery, with benefits including reduced open conversions, fewer intraoperative complications, shorter hospital stay, better long-term functional outcomes and improved oncologic outcomes. However, several challenges remain before robotics can be implemented widely on a global scale, such as higher initial capital costs, limited training access, surgeon credentialing and governance for AI-driven data analytics.