Safety, Feasibility, and Oncologic Outcomes of Versius-Assisted Colorectal Cancer Surgery: A Single Center Experience

Introduction: Robotic platforms are increasingly used in colorectal surgery. Versius is a modular robotic system whose safety and feasibility are currently being evaluated in routine clinical practice.Aim: To assess the safety, feasibility, and short-term oncologic outcomes of Versius-assisted colorectal cancer surgery in a single center during a two-year implementation period.Material and methods: A retrospective observational study was conducted, including patients undergoing elective robotic colorectal cancer resection using the Versius system between December 5, 2022, and August 27, 2025. Demographic characteristics, operative parameters (skin-to-skin time, docking time, console time, blood loss, conversions), intra- and postoperative complications (Clavien-Dindo classification), reoperations, 30-day readmissions and mortality, length of stay, and oncologic outcomes (resection margins, lymph node yield, mesorectal quality) were analyzed.Results: A total of 191 patients were included (51.8% male, mean age 69.7 9.8 years). The most common procedures were anterior resection (41.4%) and right hemicolectomy (26.7%). The median skin-to-skin operative time was 225 minutes (IQR 185-269). Median length of stay was 6 days (IQR 5-7). Conversion to laparotomy occurred in 8 patients (4.2%). Postoperative complications occurred in 40 patients (20.9%), including minor complications (Clavien-Dindo I-II) in 26 (13.6%) and major complications (≥III) in 14 (7.3%). Reoperation was required in 13 patients (6.8%), and 30-day readmission occurred in 6 (3.1%). One perioperative death was recorded (0.5%). Median lymph node yield was 22 (IQR 14-25), and ≥12 nodes were retrieved in 87.9% of patients. Complete mesorectal excision was achieved in 75.3%, with a combined rate of complete and nearly complete excision of 95.7%.Conclusions: Versius-assisted colorectal cancer surgery is feasible and safe in a center with established laparoscopic expertise. Acceptable complication rates and adequate oncologic parameters support its implementation in routine colorectal practice.