Robotic surgery for multi-visceral resection in locally advanced colorectal cancer: Techniques, benefits and future directions

Colorectal cancer accounts for 10% of diagnosed cancers globally and often presents as advanced disease, necessitating aggressive treatment. With both younger and healthier elderly patients being diagnosed, as well as potentially the need for salvage therapy post total neoadjuvant treatment, surgical options for cure include pelvic exenteration. Whilst typically performed via an open approach, there has been an increased utilisation of minimally invasive techniques including robotic surgery. Offering smaller incisions, reduced postoperative pain, and quicker recovery time than open surgery, robotic techniques have demonstrated lower blood loss, shorter hospital stays, and reduced morbidity. Moreover, the ergonomic design of robotic systems provides surgeons with comfort during long procedures and increased precision. It also offers an increased opportunity for organ preservation and reconstruction whilst maintaining adequate oncological outcomes. As robotic technology continues to evolve and combines with artificial intelligence, it is poised to play an even more significant role in the management of complex colorectal cancer cases, improving survival and long-term outcomes.