Robotic Colorectal Surgery: Beyond the Basics

Deborah S. Keller, MS, MD

Elizabeth Raskin, MD

The current issue of Clinics in Colon and Rectal Surgery is focused on advanced management of benign and malignant colorectal disease using robotic surgery. The robotic platform was introduced to address limitations of laparoscopic surgery, especially in the pelvis. Robotic colorectal surgery remains controversial, with both the supporters and opposition passionate in their stance. Initial studies showed the comparative effectiveness to laparoscopy, with higher costs. However, recent works have shown benefits in costs and outcomes, specifically in rectal cancer cases and with high volume surgeons. There is no debate that robotic colorectal surgery is showing steady growth, particularly in rectal cancer cases. The applications of robotic surgery have continued to expand. This is an exciting time, as new robotic surgery platforms and models are entering the space, increasing the competition, availability of the technology, and possibilities for procedures performed robotically.

This issue begins with describing the evolution of robotic systems, safe training and credentialing robotic surgeons, as well as implementing the technology into practice. The edition then discusses procedures for complex benign disease-specific states in inflammatory bowel disease, diverticulitis, and rectal prolapse in joint repair with urogynecology for multicompartment disease. Robotic applications for malignant disease are discussed afterward, in chapters on approaching low rectal cancer from the abdomen and transanal approaches with the robot. Following this, the issue presents advanced procedures that colorectal surgeons can incorporate into their armamentarium, including a Hartmann's reversal of an intracorporeal anastomosis, and applications in acute care. The issue ends with papers discussing specific technologies that complement robotic colorectal surgery, immunofluorescence, and augmented reality for guiding intraoperative decision making. The editors expect that the readers will find excellent tips and tricks for each of these areas which can help advance the practice of robotics for both new and experienced colorectal surgeon.

Publication History

Article published online:
03 September 2021