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World J Gastrointest Surg. Feb 27, 2016; 8(2): 143-150
Published online Feb 27, 2016. doi: 10.4240/wjgs.v8.i2.143
Overview of robotic colorectal surgery: Current and future practical developments
Sudipta Roy, Charles Evans
Sudipta Roy, Charles Evans, ST7 General Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom
Author contributions: Roy S performed the majority of the research and writing of the paper, including photography; Evans C contributed to structuring of the paper and provided senior oversight.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sudipta Roy, MBChB, MRCS, MSc, ST7 General Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom. sudiptaroy@doctors.org.uk
Telephone: +44-784-3238617 Fax: +44-247-6966090
Received: April 28, 2015
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
Abstract

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.

Keywords: Colorectal surgery, Robotic surgery, Endoscopy, Robotics, Nanotechnology, Microtechnology, Rectal neoplasms, Colonic neoplasms

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.