INTRODUCTION: Laparoscopic techniques have induced a tremendous revolution in the field of general surgery. Recent multicenter trials have demonstrated similar patient-oriented and oncologic outcomes for laparoscopic colon and rectal resections compared with their open counterparts. Meanwhile, robotic technology has gradually entered the field of general surgery, allowing increased dexterity, improved operative view, and optimal ergonomics. The objective of this study was to review the current status of clinical robotic applications in colorectal surgery. METHODS: A systematic review of the literature using the PubMed search engine was undertaken to identify relevant articles. The keywords used in all possible combinations were: surgical robotics, robotic surgery, computer-assisted surgery, colectomy, sigmoid resection, sigmoidectomy, and rectal resection. RESULTS: Thirty-nine case series or comparative nonrandomized studies were identified. A specific interest for robot-assisted rectal surgery during the past few years was recorded in the literature. The retrieved articles included 13 ileocecal resections, 220 right colectomies, 190 left colectomies/sigmoid resections, 440 anterior resections, 149 abdominoperineal/intersphincteric resections, and 11 total/subtotal colectomies. The clinical application of the da Vinci robotic system in right and left/sigmoid colectomies yielded satisfactory results in terms of open conversion (1.1 and 3.8%, respectively) and operative morbidity (13.4 and 15.1%, respectively). Robot-assisted anterior resection was accompanied by a considerably low conversion rate (0.4%), morbidity (9.7%), and adequate number of harvested lymph nodes (14.3, mean). CONCLUSIONS: Robotic applications in colorectal surgery are feasible with low conversion rates and favorable morbidity. Further studies are required to evaluate its oncologic and patient-oriented outcomes.
INTRODUCTION: Laparoscopic techniques have induced a tremendous revolution in the field of general surgery. Recent multicenter trials have demonstrated similar patient-oriented and oncologic outcomes for laparoscopic colon and rectal resections compared with their open counterparts. Meanwhile, robotic technology has gradually entered the field of general surgery, allowing increased dexterity, improved operative view, and optimal ergonomics. The objective of this study was to review the current status of clinical robotic applications in colorectal surgery. METHODS: A systematic review of the literature using the PubMed search engine was undertaken to identify relevant articles. The keywords used in all possible combinations were: surgical robotics, robotic surgery, computer-assisted surgery, colectomy, sigmoid resection, sigmoidectomy, and rectal resection. RESULTS: Thirty-nine case series or comparative nonrandomized studies were identified. A specific interest for robot-assisted rectal surgery during the past few years was recorded in the literature. The retrieved articles included 13 ileocecal resections, 220 right colectomies, 190 left colectomies/sigmoid resections, 440 anterior resections, 149 abdominoperineal/intersphincteric resections, and 11 total/subtotal colectomies. The clinical application of the da Vinci robotic system in right and left/sigmoid colectomies yielded satisfactory results in terms of open conversion (1.1 and 3.8%, respectively) and operative morbidity (13.4 and 15.1%, respectively). Robot-assisted anterior resection was accompanied by a considerably low conversion rate (0.4%), morbidity (9.7%), and adequate number of harvested lymph nodes (14.3, mean). CONCLUSIONS: Robotic applications in colorectal surgery are feasible with low conversion rates and favorable morbidity. Further studies are required to evaluate its oncologic and patient-oriented outcomes.
Authors: Ruben Veldkamp; Esther Kuhry; Wim C J Hop; J Jeekel; G Kazemier; H Jaap Bonjer; Eva Haglind; Lars Påhlman; Miguel A Cuesta; Simon Msika; Mario Morino; Antonio M Lacy Journal: Lancet Oncol Date: 2005-07 Impact factor: 41.316
Authors: P M Falk; R W Beart; S D Wexner; A G Thorson; D G Jagelman; I C Lavery; O B Johansen; R J Fitzgibbons Journal: Dis Colon Rectum Date: 1993-01 Impact factor: 4.585
Authors: Mark Buunen; Ruben Veldkamp; Wim C J Hop; Esther Kuhry; Johannes Jeekel; Eva Haglind; Lars Påhlman; Miguel A Cuesta; Simon Msika; Mario Morino; Antonio Lacy; Hendrik J Bonjer Journal: Lancet Oncol Date: 2008-12-13 Impact factor: 41.316
Authors: Heidi Nelson; Daniel J Sargent; H Sam Wieand; James Fleshman; Mehran Anvari; Steven J Stryker; Robert W Beart; Michael Hellinger; Richard Flanagan; Walter Peters; David Ota Journal: N Engl J Med Date: 2004-05-13 Impact factor: 91.245
Authors: Simon S M Ng; Ka Lau Leung; Janet F Y Lee; Raymond Y C Yiu; Jimmy C M Li; Anthony Y B Teoh; Wing Wa Leung Journal: Ann Surg Oncol Date: 2008-04-05 Impact factor: 5.344
Authors: F Corcione; C Esposito; D Cuccurullo; A Settembre; N Miranda; F Amato; F Pirozzi; P Caiazzo Journal: Surg Endosc Date: 2004-11-18 Impact factor: 4.584
Authors: Blair A Wormer; Kristian T Dacey; Kristopher B Williams; Joel F Bradley; Amanda L Walters; Vedra A Augenstein; Dimitrios Stefanidis; B Todd Heniford Journal: Surg Endosc Date: 2013-11-07 Impact factor: 4.584