Robot-assisted vs. laparoscopic rectal cancer resection: a narrative review of oncological outcomes, functional results, and future perspectives

Abstract

Robot-assisted rectal resection has increasingly gained acceptance as a minimally invasive surgical approach for rectal cancer, primarily due to its enhanced precision, dexterity, and superior visualization compared to traditional laparoscopic surgery. Accumulating evidence from randomized controlled trials, systematic reviews, and large-scale national registry analyses underscores its feasibility and safety, particularly in technically demanding scenarios such as male patients, obese individuals, and those with low rectal tumors. Robotic surgery demonstrates favorable short-term outcomes, including significantly lower conversion rates, reduced intraoperative blood loss, and accelerated postoperative recovery. Nonetheless, results regarding operative duration, postoperative complications, and cost-effectiveness remain heterogeneous. Additionally, robotic techniques may facilitate improved functional preservation, especially concerning urinary and sexual functions, attributed to superior visualization and precise nerve-sparing capabilities; however, these benefits require further rigorous validation. Continued advancements in robotic technology and growing surgical proficiency necessitate future large-scale, multicenter trials to definitively establish the long-term oncological and functional advantages. Emerging robotic platforms and technological innovations hold promise for reducing costs and enhancing accessibility. This narrative review critically examines current evidence, outlining the clinical benefits, inherent limitations, and prospective advancements in robotic-assisted surgery for rectal cancer.

Keywords

Rectal cancer / robot-assisted surgery / cost-effectiveness / functional outcomes / technological advancements

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