• Abdominoperineal resection
• Laparoscopic group
• Low anterior resection
• Open group
• Rectal resections
• Robotic-assisted surgery

• Humans
• Robotic Surgical Procedures/methods
• Laparoscopy/methods
• Male
• Female
• Rectal Neoplasms/surgery
• Rectal Neoplasms/pathology
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• India
• Aged
• Length of Stay/statistics & numerical data
• Operative Time
• Adult
• Rectum/surgery
• Postoperative Complications/epidemiology
• Blood Loss, Surgical/statistics & numerical data

• Intuitive Surgical

• Conversion to open
• Male gender
• Obesity
• Operative time
• Robotic-assisted surgery

• Humans
• Robotic Surgical Procedures/methods
• Robotic Surgical Procedures/statistics & numerical data
• Robotic Surgical Procedures/adverse effects
• Laparoscopy/methods
• Laparoscopy/statistics & numerical data
• Laparoscopy/adverse effects
• Colorectal Neoplasms/surgery
• Male
• Female
• Risk Factors
• Operative Time
• Treatment Outcome
• Conversion to Open Surgery/statistics & numerical data
• Length of Stay/statistics & numerical data
• Aged
• Postoperative Complications/etiology
• Postoperative Complications/epidemiology
• Middle Aged
• Sex Factors
• Rectal Neoplasms/surgery

• Anastomotic leakage
• Colorectal cancer
• Transanal drainage tube

• Humans
• Male
• Female
• Anastomotic Leak/prevention & control
• Aged
• Propensity Score
• Middle Aged
• Drainage/instrumentation
• Drainage/methods
• Colorectal Neoplasms/surgery
• Retrospective Studies
• Anastomosis, Surgical
• Aged, 80 and over
• Surgical Stapling
• Treatment Outcome
• Anal Canal
• Rectal Neoplasms/surgery

• Bibliometrics
• Robot
• Robotic surgery
• Visual analysis

• Bibliometrics
• Robotic Surgical Procedures/trends
• Robotic Surgical Procedures/statistics & numerical data
• Robotic Surgical Procedures/methods
• Humans

• 2022020225-JH2/1013 Applied Basic Research Program of Liaoning Province
• LJ242410159046 Basic Research Project Plan for Universities of Liaoning Provincial Department of Education

• Laparoscopic
• colectomy
• colon cancer
• overlap anastomosis
• right-sided
• robot-assisted

• anastomotic leak
• laparoscopic
• low rectal cancer
• wound infection

• Humans
• Rectal Neoplasms/surgery
• Laparoscopy/methods
• Laparoscopy/adverse effects
• Surgical Wound Infection/epidemiology
• Surgical Wound Infection/etiology
• Male
• Female
• Aged
• Middle Aged
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Adult
• Aged, 80 and over
• Anastomotic Leak/epidemiology

• 2019N086S Quanzhou City Science & Technology Program of China
• 2017FJZYLC502 Traditional Chinese Medicine Science and Technology of Fujian
• 2021LC010002 Traditional Chinese Medicine Science and Technology of Fujian

• Humans
• Robotics
• Robotic Surgical Procedures/adverse effects
• Robotic Surgical Procedures/methods
• Retrospective Studies
• Propensity Score
• Rectal Neoplasms/surgery
• Rectal Neoplasms/pathology
• Laparoscopy
• Treatment Outcome

• Body mass index
• Postoperative complications
• Rectal cancer
• Robotic surgery

• Humans
• Robotic Surgical Procedures/methods
• Retrospective Studies
• Body Mass Index
• Overweight/complications
• Overweight/epidemiology
• Flatulence/complications
• Flatulence/surgery
• Rectal Neoplasms/surgery
• Postoperative Complications/etiology
• Obesity/complications
• Obesity/epidemiology
• Laparoscopy/adverse effects
• Laparoscopy/methods
• Treatment Outcome

• 81972269 The National Natural Science Foundation of China

• Rectal neoplasms
• Robotic surgical procedures
• Single-port robotic surgery
• Total mesorectal excision

• Colorectal cancer
• Laparoscopy
• Meta-analysis
• Robotic surgical procedures

• Humans
• Flatulence/complications
• Flatulence/surgery
• Robotics
• Laparoscopy/adverse effects
• Lymph Nodes
• Colorectal Neoplasms/surgery
• Colorectal Neoplasms/complications
• Treatment Outcome
• Length of Stay
• Postoperative Complications/etiology
• Operative Time

• Humans
• Robotic Surgical Procedures/methods
• Retrospective Studies
• Robotics/methods
• Rectal Neoplasms/surgery
• Rectal Neoplasms/pathology
• Pelvis

• Colorectal cancer
• Da Vinci
• Learning curve
• Robotic surgery

• Humans
• Male
• Female
• Aged
• Robotic Surgical Procedures/methods
• Learning Curve
• Robotics
• Rectal Neoplasms/surgery
• Laparoscopy/methods
• Retrospective Studies
• Surgeons/education

• costs
• laparoscopic surgery
• meta-analysis
• rectal cancer
• rectal resection
• robotic surgery
• systematic review
• total mesorectal excision

• Chemoradiotherapy
• Laparoscopic surgery
• Open surgery
• Rectal cancer
• Robotic surgery

• abdominoperineal resection
• low anterior resection
• low rectal cancer
• rectal cancer survival
• sphincter preservation
• trends in surgery

• National Natural Science Foundation of China
• Natural Science Foundation of Shanghai

• Low rectal cancer
• Robotic surgery
• Sphincter-preserving surgery
• Total mesorectal excision

The current standard treatment for locally advanced rectal cancer is based on a multimodal comprehensive treatment combined with preoperative neoadjuvant chemoradiation and complete surgical resection of the entire mesorectal cancer. For ultra-low cases and cases with lateral lymph node metastasis, due to limitations in laparoscopic technology, the difficulties of operation and incidence of intraoperative complications are always difficult to overcome. Robotic surgery for the treatment of rectal cancer is an emerging technique that can overcome some of the technical drawbacks posed by conventional laparoscopic approaches, improving the scope and effect of radical operations. However, evidence from the literature regarding its oncological safety and clinical outcomes is still lacking. This brief review summarized the current status of robotic technology in rectal cancer therapy from the perspective of several mainstream surgical methods, including robotic total mesorectal excision (TME), robotic transanal TME, robotic lateral lymph node dissection, and artificial intelligence, focusing on the developmental direction of robotic approach in the field of minimally invasive surgery for rectal cancer in the future.

• Colorectal cancer
• RLLND
• RTME
• RTaTME
• Robotic surgery

Robotic surgery has potential benefits in the management of gastric cancer patients. This study compares the outcomes between totally robotic distal gastrectomy (TRDG) with modified port placement and arm positioning technique and conventional totally laparoscopic distal gastrectomy (CTLDG).

Fifty-two patients were enrolled into the study following a retrospective review of an in-patient database between January 2019 and June 2021. Patients who underwent gastric resection with the modified robotic technique were recruited into the study. Patients who did not receive treatment using the modified technique were excluded from the study. Data on demographic, clinical data and surgical outcomes were collected, analyzed, and presented. All statistical analyses were done using IBM SPSS statistical software.

Nineteen patients were in the TRDG group, and their mean age was 60.42 ± 11.53 years. There were no differences in demographic characteristics (all p > 0.05); nonetheless, laparoscopic patients had a significantly higher preoperative albumin level (p = 0.000). The operative time was longer in the TRDG group (223min), but the difference was insignificant. The reconstruction time was significantly shorter for the laparoscopic group (p = 0.000). Except for a significantly higher value of postoperative albumin level (p-value = 0.005) in the robotic group, there were no significant differences in all other surgical outcomes between the two groups. One (5.3%) patient had a severe complication in the robotic group compared to four (12.1%) in the laparoscopic group. Nevertheless, the differences in complications were statistically insignificant.

The modified approach is a safe and feasible in totally robotic distal gastrectomy for the treatment of gastric cancer patients.

•

The modified approach has an acceptable operative time from the initial results.

• Arm positioning
• Conventional laparoscopic distal gastrectomy
• Gastric cancer
• Modified port placement
• Robotic distal gastrectomy

Utilization of robotic surgical systems has increased over the years. Robotic surgery is presumed to have advantages of enhanced visualization, improved dexterity, and reduced tremor, which is purported to be more suitable for rectal cancer surgery in a confined space than laparoscopic or open surgery. However, evidence supporting improved clinical and oncologic outcomes after robotic surgery remains controversial and limited despite the widespread adoption of robotic surgical systems. To date, numerous observational studies and a few randomized controlled trials have failed to demonstrate that short-term, oncological, and functional outcomes after a robotic surgery are superior to those of laparoscopic surgery for low rectal cancer patients. The objective of this review is to summarize the current state of robotic surgery and its impact on low-lying rectal cancer.

• anxiety
• da vinci robot
• depression
• gastric cancer
• radical gastrectomy

• Anxiety/diagnosis
• Anxiety/epidemiology
• Anxiety/etiology
• Depression/diagnosis
• Depression/epidemiology
• Depression/etiology
• Gastrectomy/adverse effects
• Humans
• Pain/surgery
• Quality of Life
• Retrospective Studies
• Robotics
• Stomach Neoplasms/surgery
• Treatment Outcome

Robotic surgery has been taken as a new modality to surpass the technical limitations of conventional surgery. Here we aim to compare the oncologic outcomes of patients with rectal cancer receiving robotic vs. laparoscopic surgery.

Data from patients diagnosed with rectal cancer between March 2011 and December 2018 were obtained for outcome assessment at the First Affiliated Hospital of Nanchang University. All patients were separated into two groups: a robot group (patients receiving robotic surgery, n = 314) and a laparoscopy group (patients receiving laparoscopic surgery, n = 220). The primary endpoint was survival outcomes. The secondary endpoints were the general conditions of the operation, postoperative complications and pathological characteristics.

The 5-year overall survival (OS) and disease-free survival (DFS) at years 1, 3 and 5 were 96.6%, 88.7%, and 87.7% vs. 96.7%, 88.1%, and 78.4%, and 98.6%, 80.2-, and 73.5% vs. 96.2-, 87.2-, and 81.1% in the robot and laparoscopy groups, respectively (P > 0.05). In the multivariable-adjusted analysis, robotic surgery was not an independent prognostic factor for OS and DFS (P = 0.925 and 0.451, respectively). With respect to the general conditions of the operation, patients in the robot group had significantly shorter operation times (163.5 ± 40.9 vs. 190.5 ± 51.9 min), shorter times to 1^st gas passing [2(1) vs. 3(1)d] and shorter hospital stay days [7(2) vs. 8(3)d] compared to those in the laparoscopy group (P < 0.01, respectively). After the operation, the incidence of short- and long-term complications in the robot group was significantly lower than that in the laparoscopy group (15.9% vs. 32.3%; P < 0.001), especially for urinary retention (1.9% vs. 7.3%; 0.6% vs. 4.1%, P < 0.05, respectively). With regard to pathological characteristics, TNM stages II and III were more frequently observed in the robot group than in the laparoscopy group (94.3% vs. 83.2%, P < 0.001). No significant difference were observed in lymph nodes retrieved, lymphovascular invasion and circumferential resection margin involvement between the two groups (P > 0.05, respectively).

This monocentre retrospective comparative cohort study revealed short-term advantages of robot-assisted rectal cancer resection but similar survival compared to conventional laparoscopy.

• Laparoscopic surgery
• Oncologic outcome
• Rectal cancer
• Robotic surgery

• Laparoscopy
• Meta-analysis
• Rectal cancer
• Robotic
• Robotic-assisted

• Humans
• Laparoscopy
• Postoperative Complications
• Rectal Neoplasms/surgery
• Retrospective Studies
• Robotic Surgical Procedures
• Treatment Outcome

• da Vinci surgical system
• micro hand S surgical system
• rectal cancer
• robot-assisted total mesocolic excision

• Humans
• Laparoscopy
• Male
• Rectal Neoplasms/surgery
• Retrospective Studies
• Robotic Surgical Procedures
• Robotics
• Treatment Outcome

• 51875580 National Natural Science Foundation of China,China

• CMR Versius Surgical Robot System
• Low and ultralow anterior resection
• Rectal cancer
• Total mesorectal excision

• Rectal cancer
• Robotic surgery
• Single-port (SP) robot
• Single-port (SP) robotic rectal resection

RCTs are considered the standard in surgical research, whereas case-matched studies and propensity score matching studies are conducted as an alternative option. Both study designs have been used to investigate the potential superiority of robotic surgery over laparoscopic surgery for rectal cancer. However, no conclusion has been reached regarding whether there are differences in findings according to study design. This study aimed to examine similarities and differences in findings relating to robotic surgery for rectal cancer by study design.

A comprehensive literature search was conducted using PubMed, Scopus, and Cochrane CENTRAL to identify RCTs, case-matched studies, and cohort studies that compared robotic versus laparoscopic surgery for rectal cancer. Primary outcomes were incidence of postoperative overall complications, incidence of anastomotic leakage, and postoperative mortality. Meta-analyses were performed for each study design using a random-effects model.

Fifty-nine articles were identified and reviewed. No differences were observed in incidence of anastomotic leakage, mortality, rate of positive circumferential resection margins, conversion rate, and duration of operation by study design. With respect to the incidence of postoperative overall complications and duration of hospital stay, the superiority of robotic surgery was most evident in cohort studies (risk ratio (RR) 0.83, 95 per cent c.i. 0.74 to 0.92, P < 0.001; mean difference (MD) –1.11 (95 per cent c.i. –1.86 to –0.36) days, P = 0.004; respectively), and least evident in RCTs (RR 1.12, 0.91 to 1.38, P = 0.27; MD –0.28 (–1.44 to 0.88) days, P = 0.64; respectively).

Results of case-matched studies were often similar to those of RCTs in terms of outcomes of robotic surgery for rectal cancer. However, case-matched studies occasionally overestimated the effects of interventions compared with RCTs.

• Senhance surgical robotic system
• colorectal surgery
• complications
• feasibility

• laparoscopy
• rectal surgery
• robotics
• sexual function
• urological function

• Crohn’s disease
• Inflammatory bowel disease
• Robotic surgery

• Laparoscopic
• Rectal cancer
• Robotic
• Sphincter-saving procedure
• Total mesorectal excision

• Adult
• Aged
• Aged, 80 and over
• Anal Canal
• Chemoradiotherapy, Adjuvant
• Digestive System Surgical Procedures/methods
• Feasibility Studies
• Follow-Up Studies
• Humans
• Laparoscopy/methods
• Male
• Margins of Excision
• Metabolism, Inborn Errors
• Middle Aged
• Neoadjuvant Therapy
• Operative Time
• Organ Sparing Treatments/methods
• Rectal Neoplasms/surgery
• Rectal Neoplasms/therapy
• Retrospective Studies
• Robotic Surgical Procedures/methods
• Sex Factors
• Time Factors
• Treatment Outcome

• adjuvant chemotherapy
• colorectal cancer
• surgical treatment

• Oncological outcomes
• Rectal cancer
• Robotic approach
• TME

• municipal hospital
• pilot study
• rectal surgery
• robotic surgery

• Rectal cancer
• length of stay
• minimally invasive surgery
• patient readmission
• postoperative complications

• Elderly
• National in-patient sample(NIS)
• Proctectomy
• Robotic

• laparoscopic colorectal surgery
• rectal cancer
• robotic colorectal surgery
• total mesorectal excision

• Cytoreduction Surgical Procedures/methods
• Humans
• Minimally Invasive Surgical Procedures/methods
• Randomized Controlled Trials as Topic
• Rectal Neoplasms/surgery
• Treatment Outcome

• Deep venous thrombosis
• Pulmonary embolism
• Rectal surgery
• Surgical outcomes
• Venous thromboembolism

• Postoperative complications
• Rectal cancer
• Robotic-assisted surgery

• Adenocarcinoma/mortality
• Adenocarcinoma/secondary
• Adenocarcinoma/surgery
• Adult
• Aged
• Aged, 80 and over
• Female
• Follow-Up Studies
• Humans
• Laparoscopy/mortality
• Male
• Middle Aged
• Postoperative Complications
• Prognosis
• Rectal Neoplasms/mortality
• Rectal Neoplasms/pathology
• Rectal Neoplasms/surgery
• Retrospective Studies
• Robotic Surgical Procedures/mortality
• Survival Rate
• Young Adult

• intersphincteric resection
• laparoscopic total mesorectal excision
• rectal cancer
• robotic total mesorectal excision
• sphincter preservation

• Adult
• Aged
• Anastomosis, Surgical
• Body Mass Index
• Female
• Humans
• Laparoscopy/methods
• Male
• Middle Aged
• Neoadjuvant Therapy
• Operative Time
• Outcome Assessment, Health Care
• Postoperative Complications
• Propensity Score
• Prospective Studies
• Rectal Neoplasms/surgery
• Rectum/surgery
• Robotic Surgical Procedures/methods

Colorectal cancer is one of the most common cancers worldwide. Laparoscopic colorectal surgery (LCRS) is a frequently used modality. A new development in minimally invasive surgery is robot-assisted colorectal surgery (RACRS).

Prospectively collected data of 378 consecutive patients who underwent RACRS or LCRS for stage I–III colorectal cancer from Dec 2014 to Oct 2017 were analyzed. Primary outcome was oncological outcome (radical margins, number of retrieved lymph nodes, locoregional recurrence). Secondary outcomes were distant metastases, overall and disease-free survival, operation time, conversion, length of hospital stay, and intra- and post-operative complications.

206 RACRS (129 colon and 77 rectal) and 172 LCRS (138 colon and 34 rectal) procedures were included. Baseline characteristics were similar. Overall median follow-up time was 15 months (0.2–36). Oncological outcome was similar. In colon cancer, radical margins were achieved in 99.3% in RACRS group versus 98.6% in LCRS group (p = 0.60), the average number of harvested lymph nodes was 16 ± 6 versus 18 ± 7 (p = 0.16), and locoregional recurrence rate in 24 months was 3.8% vs 3.8% (p = 0.99), respectively. In rectal cancer, radical margins were achieved in 89.6% in RACRS group versus 94.3% in LCRS group (p = 0.42), the average number of harvested lymph nodes was 16 ± 8 versus 15 ± 4 (p = 0.51), and locoregional recurrence rate in 24 months was 9.5 versus 5.6% (p = 0.42), respectively. Incidence of metastasis, survival rates, operation time, length of hospital stay, and number of severe post-operative complications measured by Clavien–Dindo scores did not differ between RACRS and LCRS groups. Conversion and intra-operative complication rates were significantly lower in the RACRS group as compared to the LCRS group (3% vs 9%, p = 0.008 and 2% vs 8%, p = 0.003, respectively).

RACRS is safe in the treatment of patients with stage I–III colorectal cancer. Oncological outcome did not differ between RACRS and LCRS groups. RACRS had lower conversion and intra-operative complication rates.