Robotic Assisted Colorectal Surgery

Abstract

Background: Robotics-assisted colorectal resections are well-established and standardized procedures. The penetrance of this technique shows an exponential increase worldwide. This development will be further enhanced through the implemetation of other innovative robotics systems in the near future. Objective: Meaningful indications, set-up, operative strategy and techniques are presented and discussed. Methods: Presentation of our experiences with nearly 400 colorectal resections with the Da Vinci® SI system. Discussion of the available data and studies. Results: The features of robotic assistance are particularly helpful in technically challenging situations and complex operative procedures. Robotic assistance improves outcome after these minimally invasive operations. Oncological rectal resection, right sided hemicolectomy and anterior rectopexy are reasonable and meaningful indications for the Da Vinci® SI system. The Da Vinci® XI system and the forthcoming alternative systems from other manufacurers make complete colectomy and restorative coloproctectomy ideal interventions for robotic assistance. Conclusion: Robotics-assisted colorectal resections are well-established and standardized procedures. They improve outcome after complex procedures and will help to increase the penetrance of minimally invasive approaches in colorectal surgery. The continuous ongoing technical innovations, such as immunfluorescence, “smart” clamping (already available), navigation, in vivo microscopy, large data managment and cognitive systems (upcoming) will further change the operating theater working place. There is only one negative argument against active participation in this important development – the high costs.