Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jun 10, 2015; 6(3): 22-24
Published online Jun 10, 2015. doi: 10.5306/wjco.v6.i3.22
Robotic technology: Optimizing the outcomes in rectal cancer?
Nicolas C Buchs
Nicolas C Buchs, Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospital of Geneva, 1211 Geneva 14, Switzerland
Author contributions: Buchs NC solely contributed to this manuscript.
Conflict-of-interest: The author has no financial disclosure or conflict of interest.
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: Nicolas C Buchs, MD, Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil, 4, 1211 Geneva 14, Switzerland. nicolas.c.buchs@hcuge.ch
Telephone: +41-22-3727703 Fax: +41-22-3737707
Received: February 24, 2015
Peer-review started: February 26, 2015
First decision: April 10, 2015
Revised: April 24, 2015
Accepted: May 7, 2015
Article in press: May 8, 2015
Published online: June 10, 2015
Abstract

Minimally invasive rectal resection remains a challenging procedure, even in experienced hands. Technical limitations explain at least in part the reasons of a relatively poor adoption of laparoscopy for rectal resection, in particular for low tumors in a deep and narrow pelvis. Robotics is intended to overcome these limitations. Potentially better short-term outcomes have been published: reduced conversion rates, better functional outcomes, shorter learning curve, reduction of positive margins, better specimen… However, robotic surgery has not yet taken over as the gold standard approach for low anterior resection. Several drawbacks might indeed discourage the most fervent surgeon: the size of the robot, the lack of tactile feedback, the risk and difficulties during multiquadrant surgery, and, of course, costs. Whilst new systems might overcome most of these drawbacks, it seems obvious that the development of robotic surgery is underway. Robotics is not just another interesting technical tool, but more a new concept, which should play a role in the future.

Keywords: Robot, Laparoscopy, Total mesorectal excision, Transanal total mesorectal excision, Transanal endoscopic microsurgery, Outcomes, Rectal cancer

Core tip: The current evidences of robotic rectal resection are presented, as its potential limitations. While several better short-term outcomes have been reported (notably reduced conversion rates, better functional outcomes, shorter learning curve, reduction of positive margins, and better specimen), robotics has not yet taken over as the gold standard for low anterior resection. The reasons for this are analyzed, as the future developments in the robotic rectal field.