Several single site reports have demonstrated the safety and feasibility of the robotic platform for colectomies [17–25].

DeNoto et al. reported no complications and no conversions for 11 patients who had robotic sigmoid colectomies [17]. D’Annibale described 50 consecutive robotic right colectomies for cancer. This study showed no conversions and reasonable oncologic outcomes to include a disease-free survival of 85 % in stage III patients. This study also demonstrated the feasibility of the intracorporeal anastomosis [18]. Abodeely et al. evaluated 48 patients with various colorectal diseases to include ten with low rectal cancers and 22 with diverticulitis. There were no conversions and one anastomotic leak. Mean hospital LOS was 5.4 days. Oncologic margins were acceptable and short-term outcomes were reasonable [19]. Luca et al. studied 55 consecutive robotic procedures for rectal and left colon cancer. Complication rates and oncologic outcomes were acceptable. Anastomotic leak rate was 12.7 % [20]. Huettner et al. reported on 102 consecutive colectomies for benign and malignant neoplasia and diverticulitis. There were 59 right colectomies and 43 sigmoid resections. Conversion rate was 8.8 %. Mean hospital LOS was 3 days. Anastomotic leak rate was 0.98 % [21]. Ragupathi et al. presented 24 patients with diverticulitis who had anterior resection. There were no conversions and the complication rate was 12.5 % with no anastomotic leaks. Mean hospital LOS was 3.4 days [22].

Park et al. published their experience with robotic right colectomy with intracorporeal anastomosis for 15 patients with colon cancer. There were no conversions and oncologic results were acceptable [23]. Trastulli et al. also reported on the feasibility of robotic right colectomy with intracorporeal anastomosis for colon cancer in 20 consecutive patients. There were no conversions and margins were good [24]. Eriksen et al. performed a retrospective review of 223 robotic colon and rectal procedures for a variety of diagnoses. Conversion to open was required in 9 % of patients. Complication rates were acceptable. They found that operative time decreased with experience [25].

With some exceptions, retrospective and case-matched comparison trials have demonstrated that robotic colectomy outcomes are similar to the laparoscopic approach for diseases of the colon [26–39]. Several studies have shown no difference in estimated blood loss (EBL) , R0 resection, lymph node harvest, complications, reoperation, LOS, and operative mortality. Operative time is longer and institutional costs are higher for the robotic approach. Incisional hernia rates are less for robotic right colectomies because when compared to the extracorporeal anastomosis, the technically less demanding robotic intracorporeal anastomosis allows the specimen extraction site to be away from the midline where the incisional hernia rate is highest [34, 35]. Three studies showed shorter recovery times as measured by quicker return of gastrointestinal activity or shorter hospital LOS for the robotic group and one study showed fewer conversions for robotic right colectomies [35–38].

In one of the earliest robotic colorectal surgery reports, Delaney et al. compared six robotic and six laparoscopic procedures for various benign and malignant diagnoses. Though the robotic approach was safe in their experience, they expressed concerns about the added cost of the robotic approach [26]. D’Annibale compared 53 robotic with 53 laparoscopic colorectal procedures for various indications and found the robotic approach to be particularly advantageous for splenic flexure mobilization, dissection in a narrow pelvis, identification of the pelvic nerves, and in the construction of handsewn anastomoses. There were no differences between robotic and laparoscopic groups with respect to operative time, lymph node harvest, and hospital LOS [27]. Anvari et al. compared ten patients who had robotic colorectal surgery with the Zeus system with ten laparoscopic colorectal procedures for similar indications. There were no intraoperative complications or conversions in the robotic group. Morbidity and hospital LOS for the robotic group were comparable to the laparoscopic group. Operative times for the robotic group decreased after the first four cases [28].

Rawlings et al. compared 30 robotic and 27 laparoscopic colectomies and performed subgroup analysis of right- and left-sided procedures. Robotic right colectomies were longer because these procedures included an intracorporeal anastomosis , whereas the laparoscopic counterparts were all extracorporeal anastomoses. Operative times and costs were higher for the robotic group [29]. Spinoglio et al. compared their first 50 robotic colorectal procedures with 161 laparoscopic procedures, mostly for malignant neoplasia. Oncologic results were comparable and operative time was increased for the robot group [30]. deSousa et al. compared 40 robotic and 135 laparoscopic right hemicolectomies for various benign and malignant diagnoses. All anastomoses were done extracorporeal. Conversion rates and outcomes were similar for both procedures. Operative time and institutional costs were higher with the robotic approach [31].

Deutsch et al. conducted a retrospective review of 79 robotic and 171 laparoscopic colectomies for benign and malignant disease with subgroup analysis of the right and left side. Hospital LOS and other outcome measures were similar. Robotic operative times were longer for the left colectomy group but not for the right colectomy group [32]. In a review of the 2008–2009 National Inpatient Sample, Tyler et al. compared 160 robotic cases with 2423 laparoscopic cases of diverse benign and malignant indications. Complication rates and hospital LOS were similar for both groups. Robotic surgery was associated with more postoperative infections, fistulas, and thromboembolic events, and less pneumonia, ileus, and anastomotic complications. The robotic option was associated with higher institutional costs [33]. Morpurgo et al. compared 48 robotic right hemicolectomies with intracorporeal anastomosis to 48 laparoscopic right hemicolectomies with extracorporeal anastomosis. Operative results were similar in both groups while the robotic approach took longer. Hospital LOS was shorter for the robotic group. Anastomotic complications and incisional hernias were more common in the laparoscopic group [35]. Lim compared 30 robotic and 146 laparoscopic colectomies for sigmoid colon cancer. Clinical and oncologic outcomes were similar in both groups. The robotic mean operative time was longer [36].