Robotic colonic resection

Abstract

Innovative robotic technologies are aiming to help surgeons overcome the limits of conventional laparoscopic surgery. Recent studies have shown that robotic colorectal surgery is safe and provides favorable results in comparison to conventional laparoscopic techniques. Further studies and long-term follow-up are required to assess the outcomes and potential benefits of robotic colon surgery over laparoscopic surgery.

Robotic gastrointestinal surgery

“…7 Additionally, the robotic platform enables an integrated and supervised teaching environment without compromising operative or long-term outcomes. 4…”

“…Robotic colorectal surgery was first described in 2001, and the first robotic TME was reported in 2006, 4,8-11 but adoption of robotics into the colon and rectal surgical armamentarium has been relatively slow; it is used in only 2.8% of minimally invasive colorectal surgery. 12,13 A major reason for this low rate is the expense of robotic surgical systems, which require an initial investment ranging from $1 to $2.5 million for each unit, 14-16 as well as ongoing maintenance and repair, costly consumables, and additional team training.…”

“…17-23 However, robotic surgery can be cost-effective when performed by high-volume surgeons at high-volume centers, 24 although the number of resections that must be performed at an institution to make robotic costs manageable has yet to be determined. 4 The ROLARR (Robotic versus Laparoscopic Resection for Rectal Cancer) trial found an additional cost of only $1100 despite using the older da Vinci Si system, which had limited multiquadrant technologic capabilities, resulting in a large proportion of hybrid laparoscopic-robotic operations due to learning-curve challenges. This suggests that costs will likely decrease with newer robotic iterations that reduce docking and positioning challenges.…”

“…63-65 Intracorporeal anastomoses are also associated with a lower rate of surgical site infections and incisional hernias than those created extracorporeally. 4,66 By expanding possible sites of specimen extraction, intracorporeal anastomosis allows the surgeon to extract the specimen through a Pfannenstiel incision. Lee and colleagues reported an incisional hernia incidence of 29% compared to 0% when a Pfannenstiel extraction site was used.…”

A Systematic Review of the Role of Robotics in Plastic and Reconstructive Surgery—From Inception to the Future

“…In the USA, 80% of radical prostatectomies are now being performed robotically ( 6 ). With updates to the daVinci ® robot including a fourth instrument arm, its application is broadening to other specialties such as colorectal surgery ( 7 ). The dominance of the daVinci ® system is, however, beginning to be challenged with new competitors entering the market.…”