Published online Feb 27, 2016. doi: 10.4240/wjgs.v8.i2.143
Peer-review started: May 7, 2015
First decision: October 21, 2015
Revised: November 19, 2015
Accepted: December 8, 2015
Article in press: December 11, 2015
Published online: February 27, 2016
Minimal access surgery has revolutionised colorectal surgery by offering reduced morbidity and mortality over open surgery, while maintaining oncological and functional outcomes with the disadvantage of additional practical challenges. Robotic surgery aids the surgeon in overcoming these challenges. Uptake of robotic assistance has been relatively slow, mainly because of the high initial and ongoing costs of equipment but also because of limited evidence of improved patient outcomes. Advances in robotic colorectal surgery will aim to widen the scope of minimal access surgery to allow larger and more complex surgery through smaller access and natural orifices and also to make the technology more economical, allowing wider dispersal and uptake of robotic technology. Advances in robotic endoscopy will yield self-advancing endoscopes and a widening role for capsule endoscopy including the development of motile and steerable capsules able to deliver localised drug therapy and insufflation as well as being recharged from an extracorporeal power source to allow great longevity. Ultimately robotic technology may advance to the point where many conventional surgical interventions are no longer required. With respect to nanotechnology, surgery may eventually become obsolete.
Core tip: Robotic assistance has the potential to revolutionise the way colorectal surgery is delivered. This overview summarises the current status of robotic colorectal surgery and considers the direction of developments in robotic and endoscopic surgery and future developments in micro- and nanotechnology.