Totally Robotic Versus Totally Laparoscopic Surgery for Rectal Cancer

Abstract

In this study, perioperative and short-term postoperative results of totally robotic versus totally laparoscopic rectal resections for cancer were investigated in a comparative manner by considering risk factors including obesity, male sex, and neoadjuvant treatment. In addition to overall comparison, the impact of sex, obesity (body mass index ≥30 kg/m), and neoadjuvant treatment was assessed in patients who had a total mesorectal excision (TME). Operative time was longer in the robotic group (P<0.001). In obese patients who underwent TME, the mean length of hospital stay was shorter (7±2 vs. 9±4 d, P=0.01), and the mean number of retrieved lymph nodes was higher (30±19 vs. 23±10, P=0.02) in the robotic group. Totally robotic and totally laparoscopic surgery appears to be providing similar outcomes in patients undergoing rectal resections for cancer. Selective use of a robot may have a role for improving postoperative outcomes in some challenging cases including obese patients undergoing TME.

Systemic review and network meta‐analysis comparing minimal surgical techniques for rectal cancer: quality of total mesorectum excision, pathological, surgical, and oncological outcomes

“…The selection process is reported in Figure . Among the included studies, eight were prospective, and 15 retrospective …”

“…After removing duplicates, 739 publications were further reviewed. Further screening found that 23 studies [15][16][17][18][19][20][21][22][24][25][26][27][28][29][30][31][32][33][34][35][36]47,48 met the predefined inclusion criteria. The selection process is reported in Figure 2.…”

“…The selection process is reported in Figure 2. Among the included studies, eight were prospective, 24,25,28,29,32,34,35,48 and 15 retrospective. [15][16][17][18][19][20][21][22]26,27,30,31,33,36,47 F I G U R E 1 Network geometry for studies reporting A, complete mesorectum excision; B, near complete mesorectum excision; C, incomplete mesorectum; D, radial margin involvement; E, lymph node harvest; F, local recurrence; G, distal recurrence; H, overall complication rate; I, anastomotic leak; L, wound infection; M, urinary dysfunction; N, bowel obstruction; O, reoperation; and P, 30-day mortality.…”

Adoption of robotic technology in Turkey: A nationwide analysis on caseload and platform used

“…While that trial did not show any clear benefits of robotic technology over laparoscopy, it has major structural drawbacks, including exclusion of a large group of patients without a clear description, inclusion of a wide diversity of surgeons and techniques in terms of experience, and heterogeneity of operative techniques. In our experience, we believe that robotic technique improves specimen quality and may provide better outcomes compared with laparoscopy especially in obese patients undergoing total mesorectal excision …”

Robotic Ventral Mesh Rectopexy: Where do we Stand?

“…9 Robotics, which has been developed to overcome limitations of laparoscopy, provides better visualization and increased maneuverability in confined spaces and complicated conditions. 10 This paper aims to review the current status of the robots in VMR for the treatment of rectal prolapse.…”