World Journal of Laparoscopic Surgery

Register      Login

VOLUME 15 , ISSUE 3 ( September-December, 2022 ) > List of Articles

Original Article

Laparoscopic vs Robotic Approach for Rectal Cancer: A Meta-analysis

Aniket Agrawal, Gursev Sandlas, Charu Tiwari, Sachit Anand, Anoli Agrawal, Vivek Viswanathan

Keywords : Minimal access surgery, Open and laparoscopic surgery, Rectal cancer, Robotic surgery

Citation Information : Agrawal A, Sandlas G, Tiwari C, Anand S, Agrawal A, Viswanathan V. Laparoscopic vs Robotic Approach for Rectal Cancer: A Meta-analysis. World J Lap Surg 2022; 15 (3):224-228.

DOI: 10.5005/jp-journals-10033-1537

License: CC BY-NC 4.0

Published Online: 08-12-2022

Copyright Statement:  Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd.


Technology is evolving constantly today, and among the plethora of innovations, the one with the most potential to look forward to, in surgery, is the introduction and evolution of Robotics. Demand, as well as a pursuit of minimally invasive surgery, has increased exponentially particularly in the last decade, with Robotics being at the leading edge of this evolution. It has shown a potential to provide outcomes that were comparable to those achieved with the laparoscopic approach, with some evidence suggesting even better outcomes than laparoscopy in high-risk groups such as patients with obesity, those treated by extended procedures, and male patients. Despite all its benefits, there is still no sturdy evidence established yet about the overall superiority of robotic surgery over the laparoscopic approach. This lack of concrete evidence warranted the need for a meta-analysis that would help reveal any significant differences between the two approaches (robotics vs laparoscopic). Our study aimed to understand and establish the differences between the two approaches of rectal cancer resections, as well as to ascertain the positive efficacy and benefits of robotic surgery, if any, over the conventional laparoscopic approach. The results of this study found that the rates of sphincter preservation, intersphincteric resection (ISR), and conversion were lower with the robotic total mesorectal excision (TME) compared to laparoscopic TMEs, while no significant difference was found in the rate of major (grade ≥III) complications between the two groups.

  1. The American Cancer Society. Available at: Accessed on: February 2021.
  2. Mayo Clinic. Available at: Accessed on: February 2021.
  3. Hsieh C, Cologne KG. Laparoscopic approach to rectal cancer: The new standard? Frontiers Oncol 2020;10:1239. DOI: 10.3389/fonc.2020.01239.
  4. Katsuno H, Hanai T, Masumori K, et al. Robotic surgery for rectal cancer: Operative technique and review of the literature. J Anus Rectum Colon 2020;4(1):14–24. DOI: 10.23922/jarc.2019-037.
  5. Andolfi C, Umanskiy K. Appraisal and current considerations of robotics in colon and rectal surgery. J Laparoendosc Adv Surg Tech A 2019;29(2):152–158. DOI: 10.1089/lap.2018.0571.
  6. Ahmed J, Cao H, Panteleimonitis S, et al. Robotic vs laparoscopic rectal surgery in high‐risk patients. Colorectal Dis 2017;19(12):1092–1099. DOI: 10.1111/codi.13783.
  7. Baek SJ, Kim SH, Cho JS, et al. Robotic versus conventional laparoscopic surgery for rectal cancer: A cost analysis from a single institute in Korea. World J Surg 2012;36(11):2722–2729. DOI: 10.1007/s00268-012-1728-4.
  8. Lim DR, Bae SU, Hur H, et al. Long-term oncological outcomes of robotic versus laparoscopic total mesorectal excision of mid–low rectal cancer following neoadjuvant chemoradiation therapy. Surg Endosc 2017;31(4):1728–1737. DOI: 10.1007/s00464-016-5165-6.
  9. Valverde A, Goasguen N, Oberlin O, et al. Robotic versus laparoscopic rectal resection for sphincter-saving surgery: Pathological and short-term outcomes in a single-center analysis of 130 consecutive patients. Surg Endosc 2017;31(10):4085–4091. DOI: 10.1007/s00464-017-5455-7.
  10. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240(2):205. DOI: 10.1097/
  11. Clavien PA, Strasberg SM. Severity grading of surgical complications. Ann Surg 2009;250(2):197–198. DOI: 10.1097/sla.0b013e3181b6dcab.
  12. Asklid D, Gerjy R, Hjern F, et al. Robotic vs laparoscopic rectal tumour surgery: A cohort study. Colorectal Dis 2019;21(2):191–199. DOI: 10.1111/codi.14475.
  13. Shiomi A, Kinugasa Y, Yamaguchi T, et al. Robot-assisted versus laparoscopic surgery for lower rectal cancer: The impact of visceral obesity on surgical outcomes. Int J Colorectal Dis 2016;31(10):1701–1710. DOI: 10.1007/s00384-016-2653-z.
  14. Kim MJ, Park SC, Park JW, et al. Robot-assisted versus laparoscopic surgery for rectal cancer. Ann Surg 2018;267(2):243–251. DOI: 10.1097/SLA.0000000000002321.
  15. Colombo PE, Bertrand MM, Alline M, et al. Robotic versus laparoscopic total mesorectal excision (TME) for sphincter-saving surgery: Is there any difference in the transanal TME rectal approach?. Ann Surg Oncol 2016;23(5):1594–1600. DOI: 10.1245/s10434-015-5048-4.
  16. Park JS, Choi GS, Lim KH, et al. Robotic-assisted versus laparoscopic surgery for low rectal cancer: case-matched analysis of short-term outcomes. Ann Surg Oncol 2010;17(12):3195–202. DOI: 10.1245/s10434-010-1162-5.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.