Robotic Surgery for Colon Cancer: Principles and Pitfalls

  • Jianmin XuEmail author
  • Ye Wei
  • Dexiang Zhu
  • Qingyang Feng


Robotic surgical systems are developed to overcome the inherent limitations of traditional laparoscopic surgery, with stable camera of three-dimensional imaging, improved ergonomics, tremor elimination, ambidextrous capability, motion scaling, and flexible instruments. Several trials have showed that robotic surgery is safe and comparable, but not superior to standard laparoscopic approaches, with higher cost and longer time. Standard surgical procedures are needed for robotic colon resections. Recently several prototypes have been developed to address the current problems. And single-incision robotic surgery and natural orifice transluminal endoscopic surgery are under development now.


Robotic colon surgery Advantages Indications Perioperative preparation Surgical procedures 


  1. 1.
    Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc. 1991;1(3):144–50.Google Scholar
  2. 2.
    Koopmann MC, Heise CP. Laparoscopic and minimally invasive resection of malignant colorectal disease. Surg Clin North Am. 2008;88(5):1047–72. Scholar
  3. 3.
    Blackmore AE, Wong MT, Tang CL. Evolution of laparoscopy in colorectal surgery: an evidence-based review. World J Gastroenterol. 2014;20(17):4926–33. Scholar
  4. 4.
    Millo P, Rispoli C, Rocco N, Contul RB, Fabozzi M, Grivon M, et al. Laparoscopic surgery for colon cancer. Ann Gastroenterol. 2013;26(3):198–203.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Moghadamyeghaneh Z, Carmichael JC, Mills S, Pigazzi A, Nguyen NT, Stamos MJ. Variations in laparoscopic colectomy utilization in the United States. Dis Colon Rectum. 2015;58(10):950–6. Scholar
  6. 6.
    Roy S, Evans C. Overview of robotic colorectal surgery: current and future practical developments. World J Gastrointest Surg. 2016;8(2):143–50. Scholar
  7. 7.
    Weber PA, Merola S, Wasielewski A, Ballantyne GH. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum. 2002;45(12):1689–1694., 1695-6. Scholar
  8. 8.
    Pappou EP, Weiser MR. Robotic colonic resection. J Surg Oncol. 2015;112(3):315–20. Scholar
  9. 9.
    Butler KA, Kapetanakis VE, Smith BE, Sanjak M, Verheijde JL, Chang YH, et al. Surgeon fatigue and postural stability: is robotic better than laparoscopic surgery? J Laparoendosc Adv Surg Tech A. 2013;23(4):343–6. Scholar
  10. 10.
    Hubert N, Gilles M, Desbrosses K, Meyer JP, Felblinger J, Hubert J. Ergonomic assessment of the surgeon’s physical workload during standard and robotic assisted laparoscopic procedures. Int J Med Robot. 2013;9(2):142–7. Scholar
  11. 11.
    Xiong B, Ma L, Huang W, Zhao Q, Cheng Y, Liu J. Robotic versus laparoscopic total mesorectal excision for rectal cancer: a meta-analysis of eight studies. J Gastrointest Surg. 2015;19(3):516–26. Scholar
  12. 12.
    Xu H, Li J, Sun Y, Li Z, Zhen Y, Wang B, et al. Robotic versus laparoscopic right colectomy: a meta-analysis. World J Surg Oncol. 2014;12:274. Scholar
  13. 13.
    Rondelli F, Balzarotti R, Villa F, Guerra A, Avenia N, Mariani E, et al. Is robot-assisted laparoscopic right colectomy more effective than the conventional laparoscopic procedure? A meta-analysis of short-term outcomes. Int J Surg. 2015;18:75–82. Scholar
  14. 14.
    Lim DR, Min BS, Kim MS, Alasari S, Kim G, Hur H, et al. Robotic versus laparoscopic anterior resection of sigmoid colon cancer: comparative study of long-term oncologic outcomes. Surg Endosc. 2013;27(4):1379–85. Scholar
  15. 15.
    Tsuda S, Oleynikov D, Gould J, Azagury D, Sandler B, Hutter M, et al. SAGES TAVAC safety and effectiveness analysis: da Vinci (R) Surgical System (Intuitive Surgical, Sunnyvale, CA). Surg Endosc. 2015;29(10):2873–84. Scholar
  16. 16.
    Xu J, Qin X. Expert consensus on robotic surgery for colorectal cancer (2015 edition). Chin J Cancer. 2016;35:23. Scholar
  17. 17.
    Xu JM, Wei Y, Wang XY, Fan H, Chang WJ, Ren L, et al. Robot-assisted one-stage resection of rectal cancer with liver and lung metastases. World J Gastroenterol. 2015;21(9):2848–53. Scholar
  18. 18.
    Montalti R, Berardi G, Patriti A, Vivarelli M, Troisi RI. Outcomes of robotic vs laparoscopic hepatectomy: a systematic review and meta-analysis. World J Gastroenterol. 2015;21(27):8441–51. Scholar
  19. 19.
    Gidaro S, Altobelli E, Falavolti C, Bove AM, Ruiz EM, Stark M, et al. Vesicourethral anastomosis using a novel telesurgical system with haptic sensation, the Telelap Alf-X: a pilot study. Surg Technol Int. 2014;24:35–40.PubMedGoogle Scholar
  20. 20.
    Yi B, Wang G, Li J, Jiang J, Son Z, Su H, et al. The first clinical use of domestically produced Chinese minimally invasive surgical robot system “Micro Hand S”. Surg Endosc. 2016;30(6):2649–55. Scholar
  21. 21.
    Weaver A, Steele S. Robotics in colorectal surgery. F1000Res. 2016;5:2373. Scholar
  22. 22.
    Juo YY, Luka S, Obias V. Single-incision robotic colectomy (SIRC): current status and future directions. J Surg Oncol. 2015;112(3):321–5. Scholar
  23. 23.
    Whealon M, Vinci A, Pigazzi A. Future of minimally invasive colorectal surgery. Clin Colon Rectal Surg. 2016;29(3):221–31. Scholar
  24. 24.
    Mahvash M, Zenati M. Toward a hybrid snake robot for single-port surgery. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:5372–5. Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Jianmin Xu
    • 1
    Email author
  • Ye Wei
    • 1
  • Dexiang Zhu
    • 1
  • Qingyang Feng
    • 1
  1. 1.Colorectal Cancer Center, Zhongshan HospitalFudan UniversityShanghaiChina

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