Introduction

Article Outline

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The relevance of this issue of Seminars in Colon and Rectal Surgery on “Robotics in Colorectal Surgery” cannot be overemphasized. With the use of robotic assistance in prostatic surgery rapidly emerging as a standard of care, the application of robotic technology in other surgical disciplines is gaining increasing importance.

The first reported use of robotic assistance in colorectal surgery was in 2002, when the robot was used to mobilize the colon during a right and sigmoid colectomy. Since then, there have been several reports confirming the safety and feasibility of the robot in a variety of colorectal procedures. The da Vinci robot has overcome many limitations of conventional laparoscopy with its three-dimensional imaging, tremor filtration, motion scaling, and endowrist technology. However, the limited range of movement of the robotic arms in the current version of the robotic system has curtailed the initial enthusiasm for its use in colorectal procedures, most of which encompass several abdominal quadrants.

Various groups working independently have developed techniques to overcome this limitation and have successfully used the robot in the entire range of colorectal resections, leading to the development of many innovative port configurations, cart positions, and techniques. The primary objective of this issue is to present in one volume the techniques of robot-assisted right colon, left colon, and rectal surgical procedures.

The greatest potential for the use of the robot in colorectal surgery is in rectal resections. The superior retraction of the robotic arms and the stable camera platform greatly facilitate a precise mesorectal dissection, which is of great significance in rectal cancer. Therefore, a major portion of this issue has been dedicated to the techniques of robotic assistance in low anterior resection for rectal cancer, together with the ways to avoid and manage common complications.

A successful robotic program goes far beyond the mere acquisition of new instrumentation. Issues of nursing staff training, changes in operating room setup, timely acquisition and appropriate maintenance of instruments, as well as optimal scheduling of robotic cases across surgical specialties are vital to the success of the program. As the use of robotic assistance expands, issues of training and robotic skill acquisition will gain increasing importance. Appropriate sections of this issue have been dedicated to address these aspects.

Finally, I would like to thank all the authors who have contributed with their time, experience, and expertise to make this issue a comprehensive presentation of the current status of Robotics in Colorectal Surgery.