Abstract

Background: The literature discussed colorectal surgery using a robotic platform, which is mainly the previous da Vinci Si system. The role of the da Vinci Xi surgical system remains unclear. This study aims to evaluate the benefits and feasibility of using the robot-assisted method in colorectal surgery. Methods: We retrospectively collected 418 patients undergoing minimally invasive colorectal surgery between March 2020 and December 2021, in a single center. Patients were divided into robotic and laparoscopic groups. Primary outcomes were conversion rates to open surgery, complications, and length of stay (LOS). Secondary outcomes were post-operation functional outcomes. Results: A total of 218 patients received colectomy, while 200 patients received rectum resection. No differences were found in the conversion rate in both groups. A lower complication rate (colectomy: 7.5% vs. 23.2%, p = 0.01, rectum resection: 14.1% vs. 28.7%, p = 0.038) and shorter LOS (5 vs. 8 days, p < 0.001) was found in the robotic group. The robotic approach was associated with good functional outcomes in tolerated solid food and the termination of urinary drainage. Conclusions: The new da Vinci Xi system is safe and feasible both for colonic and rectal surgery, with reduced complications. Shorter LOS and reliable short-term outcomes may reflect both better functional recovery and surgical quality when compared to laparoscopic surgery.

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