Treatment of Colorectal Cancer through Robotic Surgery
Robotic surgery has been an emerging field in colorectal surgery. Over years there has been continuous shift towards minimally invasive procedures with enormous potential advantages but progress is impeded because of limited evidence, lack of technology and cost of expenditure. However, recent advances and feedback in robotic surgery and single-port incision in laparoscopic surgery are likely to improve surgical outcomes for treatment of colorectal cancer. Currently, laparoscopic surgery is preferred for colorectal cancer over open surgery and its usefulness is unquestionable. Laparoscopic surgery has become the standard of practice for various digestive tract surgeries. Although, robot-assisted is gold standard for various other procedures, more research is needed to prove its safety and efficacy in the treatment of colorectal cancer. Robotic surgery may overcome limitations of laparoscopic surgery such as assistant dependent camera movements, retraction issues, lack of user-friendly environment and rigid instrumentation. Prolonged operative time, learning time, increased expenses and more trauma to the patient and family are major drawbacks of robotic surgery. In recent years robot-assisted laparoscopic surgery has been increasingly applied, again with lack of comparison and evidence over conventional laparoscopic surgery. The aim of this study is to compare robotic-assisted surgery and laparoscopic-assisted surgery for the treatment of colorectal cancer (CRC).
Robotic surgery was developed to overcome the technical difficulties of conventional laparoscopy. Robotic surgery has been advantageous because of its 3-dimensional operating field, surgeon operated camera field for better visualization. In addition to that there are studies about robotic systems especially the da Vinci Xi – a robot performing colorectal surgery has been found to be better performing and more efficient over the conventional laparoscopic surgery. Almost most of the controversy surrounding the use of robotic surgery remains around the fact that robotic surgery has high expenditure and longer operative hours leading to trauma to patient and families and tiring to the doctor as well. However, further advancement in this field has been limited by a plethora of challenges that must be addressed, including difficult implementation, and still somewhat limited technologies.
Although the limitations of laparoscopic surgery are met by robotic surgery but the question arises whether these advantages are enough to offset the cost of robots. Furthermore, there has not been enough research performed over the blood loss, hospital stay, complications of the procedures and recurrence rate comparing both robotic surgery and laparoscopy surgery. The advancement in robotic surgery has leads to shorter learning curve and has been showed beneficial in various gynaecologic surgeries but its advantages in colorectal surgery are still been controversial. Also, studies are very weak comparing both techniques and better clinical and surgical outcomes of the same. This investigation means to compare robotic assisted and laparoscopic ways to deal with colon and rectal methods to illustrate any distinctions in results.
Taking everything into account, the present system meta-analysis proposes that RACS may be a superior treatment for CRC. Robotic surgery would in general have longer operative time, less blood loss, and a lower rate of change to laparotomy compared to laparoscopic surgery. However, future examinations including forthcoming randomized controlled preliminaries and cost-adequacy is needed to decide if robotic surgery will have its say in colorectal techniques.
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