Robotic-assisted surgery for colorectal cancer: Rethinking the transition from minimally invasive technology to intelligent precision surgery

Abstract

Robotic surgery has become an important component of minimally invasive colorectal cancer surgery. Compared with conventional laparoscopy, robotic platforms offer potential advantages in three-dimensional stable visualization, articulated instruments, precise manipulation, and surgeon ergonomics, and may be particularly useful in selected scenarios such as mid-low rectal cancer, narrow pelvis, obesity, post-neoadjuvant fibrosis, and complex pelvic procedures. However, robotic surgery should not be simply regarded as a universal replacement for laparoscopy. Its clinical value should be evaluated comprehensively in terms of patient benefit, indication selection, long-term oncological outcomes, functional recovery, learning curve, and cost-effectiveness. With the development of artificial intelligence, fluorescence imaging, three-dimensional reconstruction, and surgical data science, robotic platforms may evolve from minimally invasive surgical tools into digital interfaces for preoperative planning, intraoperative decision support, and postoperative quality assessment. This review article discusses the clinical positioning, ongoing controversies, intelligent development, and future application strategies of robotic-assisted colorectal cancer surgery, aiming to provide a reference for its standardized, precise, and sustainable use.