Beginning robotic assisted colorectal surgery – it's harder than it looks!

INTRODUCTION: Laparoscopy has been introduced into the field of colorectal surgery with the aim of reducing morbidity. One of the major barriers to overcome is the steep learning curve. Robotic surgery offers substantial advantages over traditional laparoscopy, which make the whole procedure more user friendly. AIM: To present our initial experiences with robotic assisted colorectal surgery. MATERIAL AND METHODS: Thirty-five patients with colorectal cancer underwent robotic assisted procedures between 2011 and 2013. RESULTS: In total we performed 16 low anterior resections, 14 right colectomies, 3 abdominosacral resections and 2 left colectomies. There were 22 males and 13 females. The mean operative time was 315 ±65 min for a low anterior resection. The mean length of hospital stay was 6.4 ±1 days. There were 4 conversions to open procedures, 2 anastomotic leaks, and 1 colovaginal fistula. The mean lymph node yield was 12.7 ±4.3. The resection margin was negative in all but 1 patient. CONCLUSIONS: We agree with the opinion that robotic surgery brings many advantages in pelvic dissections. In order to facilitate safe acquisition of robotic total mesorectal excision skills, surgeons should begin with female patients, and less advanced rectal cancer. In some instances robotic assistance can be helpful in right colectomies.