ArticleSurgical endoscopy2025
The rise of robotics: Surgical approaches for rectal cancer over time.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Current status and 10-year trends of reimbursed robot-assisted surgery in Japan: a nationwide claims-based study using the NDB Open Data.Surgical endoscopy · 2026Article
- On the edge: pathology specimen quality in robotic and laparoscopic proctectomy, a propensity score-matched study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026Article
- Circumferential resection margin status and longterm survival outcomes following robotic-assisted versus laparoscopic surgical resection for locally-advanced rectal cancer: a National Cancer Database (NCDB) study.Surgical endoscopy · 2026Article
- Robotic and laparoscopic abdominoperineal resections for anal cancer may improve outcomes compared with open surgery: insights from the National Cancer Database.Surgical endoscopy · 2026Article
- Comparative outcomes of laparoscopic and robotic colorectal cancer surgery in the NHS: real-world evidence from sequential adoption of Versius and da Vinci Xi.Journal of robotic surgery · 2026Article
- Robot-Assisted Colorectal Cancer Surgery Mitigates Early Postoperative Immunosuppression and Angiogenesis.International journal of molecular sciences · 2025Article
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Authors and funding
9 authors.
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Abstract
backgroundRobotic surgery for rectal cancer has gained attention for addressing anatomic challenges, though concerns about cost, operative time, and oncologic outcomes persist. Studies on laparoscopic surgery initially showed mixed results regarding long-term oncologic safety, but current data is favorable. Evidence supporting the robotic approach remains limited. This study examined trends in robotic surgery, including facilitation of high-quality oncologic resection, defined by lymph node yield and negative margins, using National Cancer Database (NCDB) data.
methodsA multicenter cohort study analyzed 87,611 patients with stage I-III rectal cancer undergoing definitive resection between 2010 and 2021. Outcomes included robotic surgery rates, high-quality oncologic resection (defined using lymph node yield and surgical margins), length of stay, 30-day readmission, and mortality. Outcomes were stratified into tertiles (2010-2013, 2014-2017, 2018-2021) and analyzed via univariate analysis and multivariate logistic regressions.
resultsRobotic surgery use rose from 10.1% (2010-2013) of oncologic resection to 45.7% (2018-2021) (p < 0.001). High-quality oncologic resection improved over time: 65.4% to 75.3% (p < 0.001). Compared to open surgery, robotic surgery had 1.39 times higher odds of achieving high-quality oncologic resection (p < 0.001). Despite both improving over time, robotics had higher odds than laparoscopic surgery of high-quality oncologic resection in each tertile (e.g., 2018-2021 OR 1.64, CI 1.49-1.81 vs. OR 1.44, CI 1.30-1.61; respectively). High-volume centers further increased the likelihood of successful outcomes (OR 1.6, p < 0.001). Robotic and laparoscopic approaches were associated with significantly lower mortality compared to open surgery (OR 0.63, p < 0.001; OR 0.72, p < 0.001, respectively).
conclusionRobotic surgery has significantly improved in oncologic measures, including rates of quality surgical resection and patients' overall survival, over the past decade, outperforming laparoscopic and open techniques. These findings underscore the growing role of robotic surgery in rectal cancer care and the need for formalized training and credentialing to ensure continued progress and equitable access to this technology.
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