J Korean Med Assoc.  2022 Sep;65(9):577-585. 10.5124/jkma.2022.65.9.577.

Robotic surgery for colorectal cancer

Affiliations
  • 1Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea

Abstract

Background
Robotic surgical systems were created partly to solve several constraints of laparoscopic surgery and to offer technical advantages. With a substantial body of evidence demonstrating its efficacy in rectal cancer treatment, robotic surgery will soon become another conventional treatment. However, further investigations and randomized trials focusing on primary endpoints are necessary to establish some advantages of robot-assisted colon surgery.
Current Concepts
Da Vinci Single-Site and SP platforms (Intuitive Surgical Inc.) were developed to overcome the shortcomings of single-port laparoscopic surgery. Despite the currently insufficient evidence, it seems that the SP platform addresses several limitations of single-port transabdominal or transanal surgery. Robotic transanal minimally invasive surgery and total mesorectal excision were developed to overcome conventional platforms’ limitations, using wristed instrumentation to enhance dexterity and ergonomics. Studies on the effectiveness and viability of this novel approach are ongoing. The near-infrared fluorescence technique, real-time stereotactic navigation technology, and other surgical data platforms based on artificial intelligence incorporated into the robotic system will play an important role in improving outcomes.
Discussion and Conclusion
Robotic systems for advanced colorectal cancer offer technical advantages for complex and precise surgeries. If robotic surgery costs are reduced by expanding its indications and enhancing competition among different robotic platforms, it will provide clinical benefits to more patients and reduce social healthcare costs.

Keyword

Robotic surgical procedures; Colorectal neoplasms; Therapeutics; 로봇 수술; 대장암; 치료
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