Robotic technology: Optimizing the outcomes in rectal cancer?

Minimally invasive rectal resection remains a challenging procedure, even in experienced hands. Technical limitations explain at least in part the reasons of a relatively poor adoption of laparoscopy for rectal resection, in particular for low tumors in a deep and narrow pelvis. Robotics is intended to overcome these limitations. Potentially better short-term outcomes have been published: reduced conversion rates, better functional outcomes, shorter learning curve, reduction of positive margins, better specimen… However, robotic surgery has not yet taken over as the gold standard approach for low anterior resection. Several drawbacks might indeed discourage the most fervent surgeon: the size of the robot, the lack of tactile feedback, the risk and difficulties during multiquadrant surgery, and, of course, costs. Whilst new systems might overcome most of these drawbacks, it seems obvious that the development of robotic surgery is underway. Robotics is not just another interesting technical tool, but more a new concept, which should play a role in the future.