Current status and development of robotic rectal cancer surgery

Robotic surgical systems, with advantages such as 3D visualization, rotating instruments, and stable imaging, are increasingly utilized in transabdominal and transanal approaches for rectal cancer surgery. Compared to traditional laparoscopy, robotic systems could educe the technical difficulty of total mesorectal excision (TME) and enhance pelvic autonomic nerve preservation, while demonstrating comparable long-term outcomes. However, the high cost and limited clinical benefits have led to reflection. Controversies persist regarding prolonged operative time, lack of haptic feedback and limited cost-effectiveness. Studies suggest robotic surgery may benefit patients with complex conditions such as obesity, narrow pelvis or low rectal tumors. The rapid development of domestic surgical robots is expected to break market monopolies, reduce costs and expand applications through telemedicine. Future efforts should focus on identifying optimal patient cohorts and generating high-quality evidence to refine the clinical utility of robotic surgery.