title: Beginning robotic assisted colorectal surgery - it's harder than it looks!
abstract: BACKGROUND
  Laparoscopy has been introduced into the field of colorectal surgery with the aim of reducing morbidity. One of the major barriers to overcome is the steep learning curve. Robotic surgery offers substantial advantages over traditional laparoscopy, which make the whole procedure more user friendly.
  
  
  OBJECTIVE
  To present our initial experiences with robotic assisted colorectal surgery.
  
  
  METHODS
  Thirty-five patients with colorectal cancer underwent robotic assisted procedures between 2011 and 2013.
  
  
  RESULTS
  In total we performed 16 low anterior resections, 14 right colectomies, 3 abdominosacral resections and 2 left colectomies. There were 22 males and 13 females. The mean operative time was 315 ±65 min for a low anterior resection. The mean length of hospital stay was 6.4 ±1 days. There were 4 conversions to open procedures, 2 anastomotic leaks, and 1 colovaginal fistula. The mean lymph node yield was 12.7 ±4.3. The resection margin was negative in all but 1 patient.
  
  
  CONCLUSIONS
  We agree with the opinion that robotic surgery brings many advantages in pelvic dissections. In order to facilitate safe acquisition of robotic total mesorectal excision skills, surgeons should begin with female patients, and less advanced rectal cancer. In some instances robotic assistance can be helpful in right colectomies.
authors.affiliation: Department of Surgical Oncology, Regional Specialized Hospital, Wroclaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Zawadzki
authors.affiliation: Department of Surgical Oncology, Regional Specialized Hospital, Wroclaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Rząca
authors.affiliation: Department of Surgical Oncology, Regional Specialized Hospital, Wroclaw, Poland.
authors.forename: Roman
authors.initials: R
authors.lastname: Czarnecki
authors.affiliation: Department of Surgical Oncology, Regional Specialized Hospital, Wroclaw, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Obuszko
authors.affiliation: Department of Surgical Oncology, Regional Specialized Hospital, Wroclaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Jacyna
authors.affiliation: Department of Surgical Oncology, Regional Specialized Hospital, Wroclaw, Poland.
authors.forename: Luke
authors.initials: L
authors.lastname: Stewart
authors.affiliation: Department of Surgical Oncology, Regional Specialized Hospital, Wroclaw, Poland ; Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Witkiewicz
keywords: colorectal cancer; laparoscopy; robotic surgery