title: Does robotics improve minimally invasive rectal surgery? Functional and oncological implications.
abstract: OBJECTIVE
  Robot-assisted surgery has been reported to be a safe and effective alternative to conventional laparoscopy for the treatment of rectal cancer in a minimally invasive manner. Nevertheless, substantial data concerning functional outcomes and long-term oncological adequacy is still lacking. We aimed to assess the current role of robotics in rectal surgery focusing on patients' functional and oncological outcomes.
  
  
  METHODS
  A comprehensive review was conducted to search articles published in English up to 11 September 2015 concerning functional and/or oncological outcomes of patients who received robot-assisted rectal surgery. All relevant papers were evaluated on functional implications such as postoperative sexual and urinary dysfunction and oncological outcomes.
  
  
  RESULTS
  Robotics showed a general trend towards lower rates of sexual and urinary postoperative dysfunction and earlier recovery compared with laparoscopy. The rates of 3-year local recurrence, disease-free survival and overall survival of robotic-assisted rectal surgery compared favourably with those of laparoscopy.
  
  
  CONCLUSIONS
  This study fails to provide solid evidence to draw definitive conclusions on whether robotic systems could be useful in ameliorating the outcomes of minimally invasive surgery for rectal cancer. However, the available data suggest potential advantages over conventional laparoscopy with reference to functional outcomes.
authors.affiliation: Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Guerra
authors.affiliation: Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Pesi
authors.affiliation: Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Amore Bonapasta
authors.affiliation: Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Perna
authors.affiliation: Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Di Marino
authors.affiliation: Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Annecchiarico
authors.affiliation: Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Coratti
mesh_terms: D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: erectile dysfunction; general surgery; laparoscopy; rectal neoplasms; robotics, treatment outcome