Is robotic rectal resection the preferred option for resectable cancer?

Abstract

The ultimate goal of rectal cancer surgery is to achieve a negative circumferential, distal resection margin and intact mesorectal excision; however, controversy remains as to what is the best approach. Based on the current evidence, open surgery remains the "gold standard", however recent improvements in minimally invasive surgery (MIS) techniques with the introduction of robotic surgery and transanal total mesorectal excision have questioned the historical approach of open rectal dissection. A robotic system (da Vinci) overcomes many of the limitations of laparoscopic surgery. A robotic system is more like an open surgery: it gives a 3-dimensional magnified view, endowrist movements, has a shorter learning curve when compared with laparoscopic surgery, with the added advantage of an MIS procedure. However, the higher cost associated with robotic surgery has limited uptake of this approach in rectal cancer surgery in many parts of world.