Systematic Review
Copyright ©2014 Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Jun 15, 2014; 6(6): 184-193
Published online Jun 15, 2014. doi: 10.4251/wjgo.v6.i6.184
Table 1 Characteristics of studies on robotic rectal surgery
Ref.CountryYearStudy typeNo. of robotic patientsGenderM:FMean age (yr)BMI (kg/m2)Robotic TechniqueType of operation
AR/LARISRAPRHartmann's operation
Baik et al[24]South Korea2009Comparison5637:1960.023.4Hybrid56---
Ng et al[40]Singapore2009Case Series85:355.01-Hybrid8---
Patriti et al[37]Italy2009Comparison2911:1868.024.0Hybrid1955-
Bianchi et al[38]Italy2010Comparison2518:769.024.6Total/hybrid18-7-
Pigazzi et al[32]United States, Italy2010Case Series14387:5662.026.5Total/hybrid803231-
Zimmern et al[33]United States2010Case Series5834:2460.927.5Hybrid47-11-
Baek et al[34]United States2011Comparison4125:1663.625.7Hybrid3326-
Koh et al[41]Singapore2011Case Series2013:861.023.8Total19-1-
Kwak et al[25]South Korea2011Comparison5939:2060.0123.3Total545--
Leong et al[26]South Korea2011Case Series2923:661.5123.3Total-29--
Park et al[27]South Korea2011Comparison5228:2457.323.7Hybrid52---
Kim et al[28]South Korea2012Comparison10071:2957.024.0Total100---
Park et al[35]United States2012Case Series3016:1458.0127.6Reverse-hybrid5196-
Shin et al[29]South Korea2012Comparison17---Total/hybrid17---
Erguner et al[42]Turkey2013Comparison2714:1354.028.3Total27---
Kang et al[30]South Korea2013Comparison165104:6161.223.1Total164--1
Park et al[31]South Korea2013Comparison4028:1257.323.9Hybrid-40--
Stanciulea et al[43]Romania2013Case Series10066:3462.026.0Total/Hybrid77-23-
D’Annibale et al[39]Italy2013Comparison5030:2066.0-Total502---
Fernandez et al[36]United States2013Comparison1313:067.9-Hybrid5-8-
Total1062680:38261.124.9831132981
1median value;
2TME: Paper did not specify operation. AR: Anterior resection; LAR: Low anterior resection; ISR: Intersphincteric resection; APR: Abdominoperineal resection.
Table 2 Perioperative and postoperative outcomes
Ref.No. of patients
Conversion (%)
Mean OR time (min)
Blood loss (mL)
Overall post-op morbidity (%)
Anastomotic leak (%)
Erectile dysfunction (%)
Voiding dysfunction (%)
LOS (d)
RobLapRobLapRobLapRobLapRobLapRobLapRobLapRobLapRobLap
Baik et al[24]5657010.5190.1191.1--10.719.31.87.0----5.77.6
Ng et al[40]8NA0NA193.8NAminNA12.5NA0NA----5.0NA
Patriti et al[37]2937018.9202.0208.0137.0127.026.032.86.82.75.516.6--11.99.6
Bianchi et al[38]252504.0240.0237.0--16.024.04.08.0----6.56.0
Pigazzi et al[32]143NA4.7NA297.0NAminNA41.3NA10.5NA----8.3NA
Zimmern et al[33]58NA3.7NA338.0NA232.0NA25.9NA3.4NA----6.0NA
Baek et al[34]41417.322.0296.0315.0--22.026.87.32.4----6.56.6
Koh et al[41]20NA0NA306.0NA--23.8NA0NA----6.4NA
Kwak et al[25]596003.4270.0228.0--32.226.713.610.2------
Leong et al[26]29NA0NA325.0NA--37.9NA10.3NA----9.01NA
Park et al[27]5212300232.6158.1--19.212.29.65.6--01.610.49.8
Kim et al[28]100NA0NA188.0NA--11.0NA2.0NA36.6NA6.0NA7.1NA
Park et al[35]30NA0NA369.0NA100.0NA36.7NA4.2NA0NA0NA4.01NA
Shin et al[29]171201.0396.5298.8188.8229.216.7220.0200--1.02.010.79.6
Erguner et al[42]273700280.0190.050.0125.011.121.608.102.7--4.05.0
Kang et al[30]1651650.61.8309.7277.8133.0140.120.627.97.310.8--2.44.210.813.5
Park et al[31]404000225.0183.745.759.215.012.57.55.0AAAA10.611.3
Stanciulea et al[43]100NA4.0NA180.01NA150.01NA30.0NA9.0NA3.8NA7.7NA10.01NA
D’Annibale et al[39]5050012.0270.01280.01--10.022.010.022.05.656.5AA8.0110.01
Fernandez et al[36]13598.017.0528.01344.0157.01200.0--20.07.0----13.018.01
1Median;
2Overall figures for colorectal resections (not just rectal). OR: Operating room; LOS: Length of stay; A: Erectile and voiding dysfunction was assessed and scored with the International Index of Erectile Function score and/or the International Prostate Symptom score respectively; NA: Not available.
Table 3 Oncological outcomes
Ref.No. of patients
Mean follow-up (mths)
NeoCRT (%)
Lymph nodes harvested (mean)
TME grade complete (%)
CRM +ve (%)
DRM (cm)
Robotic Recurrence (%)
3 yr Robotic Survival (%)
RobLapRobLapRobLapRobLapRobLapRobLapRobLapDSOS
Baik et al[24]565714.3 (both)8.912.218.418.792.975.47.18.84.03.6--7.6
Ng et al[40]8NA1.5NA--12.9NA--0NA> 2.0NA--NA
Patriti et al[37]293729.218.724.15.410.311.2--002.14.5None100.09.6
Bianchi et al[38]252510.0 (both)52.040.019.718.2--04.02.02.0None-6.0
Pigazzi et al[32]143NA17.4NA65.1-14.1NA--0.7NA2.9NA1.577.6NA
Zimmern et al[33]58NA13.2NA39.7NA14.1NA--0NA--5.2-NA
Baek et al[34]4141--80.543.913.116.2--2.44.93.63.8--6.6
Koh et al[41]20NA--9.5NA17.8NA--5.3-3.7---NA
Kwak et al[25]596017.013.013.68.520.021.0--1.70-----
Leong et al[26]29NA--37.9NA16.0NA--7.0NA0.8NA--NA
Park et al[27]52123--23.18.119.415.9--1.92.42.83.2--9.8
Kim et al[28]100NA24.0NA32.0NA20.0NA--1.0NA2.7NA--NA
Park et al[35]30NA--66.7NA20.0NA83.3NA0NA----NA
Shin et al[29]1712----18.4215.92--------9.6
Erguner et al[42]2737--14.821.616.016.0100.070.6004.04.0--5.0
Kang et al[30]16516522.41 (both)23.621.815.015.6--4.26.71.92.0---
Park et al[31]40406.06.080.05012.913.3--7.55.01.41.3---
Stanciulea et al[43]100NA24.01NA58.0NA14.01NA--1.0-3.0-2.0NA90.0
D’Annibale et al[39]505012.012.068.056.016.513.8--003.03.0---
Fernandez et al[36]1359--77.054.016.020.069.073.002.0-----
1Median;
2Overall figures for colorectal resections (not just rectal). Rob: Robotic-assisted surgery; Lap: Conventional laparoscopic surgery; NeoCRT: Neoadjuvant chemoradiotherapy; TME: Total mesorectal excision; CRM: Circumferential resection margin; DRM: Distal resection margin; DS: Disease free survival; NA: Not available.
Table 4 Cost of Robotic rectal surgery
Ref.CountryYearStudy typeNo. of rectal cancer patients
Average total hospitalisation cost (United States $)
P value
RoboticLaparoscopicOpenRoboticLaparoscopicOpen
Baik et al[24]
United States
2011
Comparison
41
41
-
83915
62601
-
0.092
Kwak et al[25]
South Korea
2011
Comparison
59
59
-
Robotic x3 Laparoscopic cost
NA
NA
Leong et al[26]
South Korea
2011
Case Series
29
-
-
Robotic x3 Laparoscopic cost
-
-
Kim et al[28]South Korea2012Comparison100-10012-150005000--
Rob: Robotic-assisted surgery; Lap: Conventional laparoscopic surgery; NA: Not available.