title: Robotic colonic surgery: is it advisable to commence a new learning curve?
abstract: BACKGROUND
  Robotic surgery has potential advantages in rectal and pelvic surgery, in which the dissection is performed within a confined operative field. However, the position of robotic colonic surgery remains largely undefined with limited insight of whether it offers any potential advantages over open or laparoscopic colon surgery.
  
  
  OBJECTIVE
  The aim of this systematic review was to compare the short-term outcomes of the published robotic colonic surgery with those of laparoscopic colonic surgery.
  
  
  METHODS
  The search was performed in September 2012 with the use of PubMed, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. The search terms used were "colorectal," "colon," "colectomy," and "robotic/robot."
  
  
  METHODS
  All studies reporting outcomes on robotic colonic resection were included in the review process. Colonic robotic data were compared with data on the short-term outcomes of laparoscopic colonic surgery from a Cochrane review and 4 main randomized controlled trials.
  
  
  METHODS
  A comparison was conducted of robotic colonic surgery vs standard laparoscopic colonic surgery.
  
  
  METHODS
  Short-term outcomes and the complication profile of colonic robotic surgery were compared with conventional multiple-port laparoscopic colonic surgery.
  
  
  RESULTS
  Fifteen robotic colonic surgery articles with 351 patients (173 males, 178 females) were considered for analysis. The operative time and financial cost of robotic colonic surgery was greater than standard laparoscopic colonic surgery with comparable short-term outcomes and early postoperative complications profile.
  
  
  CONCLUSIONS
  The present evidence on robotic colonic surgery has shown both feasibility and a safety profile comparable to standard laparoscopic colonic surgery. However, operative time and cost were greater in robotic colonic surgery, with no difference in the length of postoperative stay in comparison with standard laparoscopic colonic surgery. Whether the general surgical community should embark on a new learning curve for robotic colonic surgery can only be answered in the light of future studies.
authors: Laparoscopic Colorectal Surgery & Training Unit, Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom.
authors: Andrew Kai-Yip
authors: AK
authors: Fung
authors: Emad H
authors: EH
authors: Aly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003107:Colorectal Surgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome