Robotic colectomy: is it necessary?

Abstract

More than 20 years ago the introduction of laparoscopic surgery represented a paradigm shift in the management of colorectal cancer. In most recent years robotic surgery is becoming a viable alternative to laparoscopic and traditional open surgery. The major clear advantages of robotic surgery in comparison with laparoscopy are the lower conversion to open surgery rates and the shorter learning curve. However, the role of robotics in colorectal surgery is still largely undefined and different with respect to its application in abdominal versus pelvic surgery. As for colon cancer there are emerging data that laparoscopic and robotic surgery have the same advantages in terms of faster recovery, although robotic-assisted colectomy is associated with costs increase of care without providing clear reduction in overall morbidity or length of stay. Long-term outcomes for laparoscopic versus robotic colonic resections remain still largely undetermined and randomized controlled clinical trials are required to establish a possible difference in outcomes. Interesting issues for the educational aspects are associated with robotic surgery, as the double console allows the resident to take part actively at the surgical procedure since the beginning of his surgical experience.