Colorectal surgery has evolved significantly over the past thirty years. While open surgery techniques were the gold standard prior to the 1990s, now laparoscopic approaches make up 40–50% of all colorectal tissue cutting procedures. Laparoscopic procedures are operations performed in the abdomen using small incisions. Currently, robots perform the smallest, least invasive incisions possible. In fact, the evolution of colorectal surgery closely follows the evolution of robotics. Yet, there is still a human element involved when it comes to surgeons who are continually training to perform these techniques.
In July of 2,000 robotic surgery was FDA-approved for general abdominal surgery. This would have a huge impact on pelvic surgery. Urologic and gynecological professionals endorsed the move to robotic surgery from the start for pelvic surgery. Some of the advantages of robotic laparoscopy included seven degrees of movement with micro-wristed instruments, a magnified three-dimensional view without interference from hand movement, a natural hand-eye target axis, and ergonomic comfort. With these improvements, more surgeons came to use robotic techniques.
Robotic laparoscopic procedures have increased steadily ever since. As robotic colorectal surgeries have increased, surgeons have had to evolve as well. They had to learn new skills to become proficient, safe, and independent with robotic laparoscopic techniques. Although the learning curve was steep, surgeons quickly evolved to meet rising standards. Since 2008 trainees in general surgery have been required to show competence in fundamental laparoscopy.
By 2018, studies had shown that for the treatment of colorectal cancer, robotic procedures were superior. They result in decreased postoperative complication rates, shorter post-procedure stays, and decreased overall cost. With all other outcomes being equal, more and more surgeons choose robotic laparoscopic procedures. Additionally, as the number of trained operators increase along with improvements in technology, the cost of robotic procedures will continue to decrease, making it a more accessible option.
From open procedures to laparoscopic procedures, and then robotic laparoscopic procedures, colorectal surgery has changed significantly within thirty years. The benefits of robotic laparoscopic procedures drive their popularity. Meanwhile, surgeons have grown in skill and knowledge. Advancements in technology have made minimally invasive procedures possible. Moving into the future, advancements in technology and training will continue to drive the evolution of robotic laparoscopy for colorectal surgeries.