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Updated: Aug 10, 2026
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Robotic Intracorporeal Single-Stapled Anastomosis (RiSSA): Indications, Technical Benefits, and Current Limitations
Marco Palucci1, Igor Monsellato1, Fabio Giannone1
1Division of Hepato-Pancreato-Biliary, Oncologic and Robotic Surgery, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Background:
Robotic surgery has significantly advanced colorectal procedures, yet achieving an optimal anastomotic technique remains challenging. The Robotic Intracorporeal Single-Stapled Anastomosis (RiSSA) has been introduced to overcome the limitations of the conventional double-stapled approach, such as intersecting staple lines and 'dog ears', which are potential structural weak points.
Methods:
A comprehensive search of PubMed, Embase, Scopus, and Web of Science was performed through March 2026 using the keywords 'robotic colorectal anastomosis', 'robotic single-stapled anastomosis', and 'RiSSA'.
Results:
RiSSA was reviewed from its origin to recent applications, focussing on its technical rationale, procedural steps, and indications, including colorectal cancer, inflammatory bowel disease, and gynaecological conditions such as deep endometriosis. Advantages and limitations were critically assessed.
Conclusions:
Available evidence suggests that RiSSA is a feasible and promising technique; however, high-quality prospective studies are needed to better define its comparative benefits and its long-term oncological and functional outcomes.
