Abstract Background Rectal cancer (RC) has the 10th highest cancer related death-rate worldwide, traditionally treated with a laparoscopic approach, robotic surgery is now seeing an increase in popularity. Purpose To compare outcomes of laparoscopic and robotic surgery for RC. Methods This systematic review searched the current literature in PubMed, EMBASE and Cochrane library, to collate data on surgery for RC, both robotically and laparoscopically to compare their rates of conversion to open surgery, positive circumferential resection margin (+CRM), length of hospital stay (LHS) and other complications. Results This paper reviewed 18 studies with a total number of 8667 patients, whose consensus favoured robotic surgery in conversion rate, LHS, and overall complication rate. Robotic surgery for RC was also proved to be non-inferior to laparoscopic methods in relation to +CRM percentage. Conclusions A robotic approach to RC may allow for a shorter length of stay, fewer complications and comparable +CRM to laparoscopy. Longitudinal studies of high-quality design need to be performed to assess reasons for heterogeneity between the results of this study. Studies assessing cost-benefit analysis between laparoscopic and robotic methods also need to be performed.
Smith et al. (2026) studied this question.