Minimally invasive surgery for locally advanced rectal cancer: recent advances and future developments

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SUMMARYLaparoscopic rectal surgery is technically challenging, difficult to perform and has a steep learning curve. Initial studies comparing laparoscopic and open total mesorectal excision indicate that laparoscopy is associated with decreased hospital stays, reduced postoperative pain and equivalent oncologic outcomes, although definitive randomized controlled trial results evaluating laparoscopy for rectal cancer are still pending. Robotic proctectomy is thought to provide additional benefits to the patient (i.e., reduced sexual and bladder dysfunction postoperatively). It can be performed either as a hybrid technique accompanied with laparoscopic splenic flexure mobilization, or as an entirely robotic procedure. Future investigations into robotic surgery and other new technologies that have potential use in rectal cancer surgery will be critically important as we seek to optimize patient outcomes.

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