A Mapping of Operative Heterogeneity in Robotic Splenic Flexure Cancer Surgery, Focusing on Vascular Ligation and...

Area of Science:

• Surgical Oncology
• Colorectal Surgery
• Robotic Surgery

Background:

• Splenic flexure cancers are complex colorectal malignancies with uncertain optimal surgical approaches.
• Robotic surgery offers potential benefits but operative details are inconsistently reported.
• Variability in vascular supply and lymphatic drainage complicates surgical planning.

Purpose of the Study:

• To map operative heterogeneity in robotic splenic flexure cancer surgery.
• Focus on resection extent, vascular ligation, reconstruction strategy, and technical configuration.
• Synthesize current practices in robotic splenic flexure cancer resection.

Main Methods:

• Structured scoping review following PRISMA-ScR guidelines.
• Searched MEDLINE (PubMed) and Embase (Ovid) from inception to January 2026.
• Included studies reporting robotic resection for primary splenic flexure colon cancer with operative detail.

Main Results:

• Sixteen studies with 97 robotic resections were analyzed.
• General agreement on segmental resection with specific artery ligation, but variability in vein management and reconstruction.
• Inconsistent terminology and reporting of mesocolic excision and lymphadenectomy.

Conclusions:

• Robotic splenic flexure surgery demonstrates consensus on resection strategy but significant variation in technical execution.
• Discrepancies likely stem from reporting differences rather than oncological intent.
• Standardized operative descriptions are crucial for evidence-based development in this challenging surgical area.