J.Jpn. Surg. Soc.. 123(6): 531-537, 2022

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Feature topic

CURRENT STATUS AND PROSPECTS OF ROBOT-ASSISTED LAPAROSCOPIC SURGERY FOR RECTAL CANCER

Robot-assisted laparoscopic surgery (RALS) for rectal cancer has been rapidly introduced in Japan since insurance coverage began in 2018. As of April 2022, RALS for colon cancer has also been covered by insurance, and the number of RALS in the colorectal field is expected to increase.
RALS is expected to be useful in the narrow pelvic space, making full use of articulating instruments, three-dimensional view, enhanced dexterity with tremor filtration, and motion scaling to overcome the difficulty of conventional laparoscopic surgery (CLS). Although there is currently no robust clinical evidence supporting the benefit of RALS for rectal cancer, there are an increasing number of reports based on large cohort studies and databases, which indicate the advantages over CLS, including a lower rate of conversion to laparotomy and lower rates of postoperative urinary and sexual dysfunction.
The results of future clinical trials, particularly with regard to oncological aspects and prognosis, will be of interest. In terms of education, there is an increasing number of reports on the usefulness of RALS, and this is an aspect that holds great promise for the future.
In this article, we summarize the evidence for RALS for rectal cancer from several angles and discuss future prospects.

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