Robotic Right Colectomy: the italian experience

Minimally invasive surgery has gained worldwide acceptance in the treatment of colonic cancer in the last decades, thanks to its well-known benefits in terms of 30-day postoperative outcomes and equivalent long-term oncological results. Nevertheless, the penetrance of laparoscopic colectomy still remains low. A main controversial issue remains about whether the anastomosis should be performed intra- or extracorporeally. Furthermore, the introduction of the concept of complete mesocolic excision (CME), together with its potential long-term oncological advantages, has led to another matter of debate when dealing with laparoscopic right colectomy. The principles of CME may potentially increase the technical difficulties of minimally invasive surgery, especially when dealing with right colon cancer. Robotic technology could allow for an easier fashioning of intracorporeal anastomosis and for a safe high vascular ligation with CME, provided that structured training programs and learning modules are applied. In this chapter, we present our technique and outcomes of bottom-up robotic right colectomy with CME and intracorporeal anastomosis.