Latest developing surgical technique for colorectal cancer

This review analyzed the available literature on the role, efficacy and safety of robotic surgery in comparison to laparoscopic surgery in patients with colorectal cancer.

Laparoscopic colorectal surgery (LCS) or “minimally invasive” surgery is a specialized technique for performing colorectal cancer surgery. In this technique, the surgeon makes a few small cuts in the abdomen and uses a camera to view the inside the abdomen and remove the cancer. However, LCS has been associated with a number of limitations, especially when the procedure involves rectal cancers (cancer in the lowest part of the bowel).

Robotic surgery is a technique in which the surgeon uses a computer and robotic arms that translate into the surgeon’s hands. Different surgeons use robotic surgery alone, as a single-stage operation, or as a multiple stage technique. Others prefer using both laparoscopic and robotic surgical techniques (hybrid technique). Robotic surgery can access hard-to-reach areas of a patient’s body more easily through smaller surgical cuts compared to LCS. This analysis sought to evaluate the efficacy and safety of robotic colorectal cancer surgery.

A number of studies that reported outcomes of robotic colorectal surgery were reviewed. Several studies showed that it is easier for a surgeon to learn how to use robotic surgery (shorter learning curve) than LCS. However, having prior laparoscopic skills further shortens the learning curve in acquiring robotic skills. Some studies showed that robotic surgery provides clear visibility of the area under operation and reduces the physical strain that surgeons face during an operation.

Five studies on colon cancer showed that there is no significant difference between LCS and robotic surgery in terms of post-surgery outcomes. However, robotic surgery has been found to take longer time and is more expensive than LCS. A review on rectal surgery showed that robotic surgery resulted in fewer post-operative short-term complications in some patients. Several studies showed also showed that robotic surgery was associated with more benefits compared to LCS for obese patients and for those who received chemoradiotherapy (a combination treatment between chemotherapy and radiotherapy) before surgery.

This review showed that despite the high costs involved, robotic surgery can be as effective and safely used in both colon and rectal surgery compared to LCS. 

This review relied on the analyses and studies from various trials done in the past. The quality of the methodologies used in these trials was not confirmed.

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