Robotic Colonic Surgery in Elderly and Octogenarian Patients: Chronological Age Alone Does Not Predict Severe Complications

Introduction The role of robotic colonic surgery in very elderly patients remains debated, and chronological age is often considered a limiting factor. This study compared short‐term outcomes between elderly and octogenarian patients undergoing robotic colonic surgery and identified predictors of severe postoperative complications. Methods Patients aged ≥ 65 years who underwent robotic colonic resection between 2017 and 2025 were retrospectively analysed. Patients were divided into 65–79 years and ≥ 80 years groups. Complications were graded according to the Clavien–Dindo classification. Logistic regression identified predictors of severe complications (grade ≥ 3). Results Overall, 135 patients were included. Despite higher ASA scores in octogenarians, postoperative outcomes were comparable between the groups. No differences were observed in operative time, length of stay, or mortality. Conversion to open surgery independently predicted severe complications; chronological age was not associated with increased risk. Conclusions Robotic colonic surgery is safe in selected elderly patients. Age alone should not contraindicate robotic surgery.