Robotic Surgery in Colorectal Cancer

Background: In the last two decades, colorectal surgery has seen a dramatic advancement in from open to laparoscopic and now, robotic surgery. The aim of this article is to review the role of robotic surgery in colorectal cancer, especially in comparison with laparoscopic surgery. Methods: A literature search was performed using PUBMED and Google- Scholar for all papers published discussing Robotic surgery in colorectal cancer upto July 2014. We also reviewed articles comparing laparoscopic colorectal surgery versus robotic colorectal surgery. Results: Robotic colectomies had a mean operative time of 224 minutes and mean estimated blood loss of 47.67 mls. The rate of conversions to open varied from 0% to 5%. Robotic colectomies were slightly longer compared to laparoscopic colectomies. But comparable with number of retrieved lymph nodes and postoperative morbidity. Robotic rectal surgery had a mean operative time of 269 minutes (range, 170-700 minutes). Conversion rates for the robotic group were 0% - 8% in comparison with 0% - 22% for the laparoscopic group. The median anastomotic leak rate was 7.3% for the robotic group and 6.3% for the laparoscopic group. Rates of erectile dysfunction varied from 0% -36.6% after robotic surgery to 1% - 56.5% after laparoscopic surgery. With oncologic outcomes, robotic surgery was comparable with laparoscopic surgery. Conclusions: Robotic surgery is safe, feasible and suitable for colorectal cancer. Compared to laparoscopic surgeries there are fewer conversions to open and blood loss, with comparable postoperative and oncologic outcomes.