Robotic surgery in colorectal emergencies: a systematic review of current evidence

May 2026

Background Although laparoscopy continues to be the predominant minimally invasive approach in most emergency settings, the advantages of robotics, well established in elective surgery, are currently being explored in selected scenarios and specialized centres. Methods A systematic review was conducted using PubMed, Cochrane Library and Scopus databases until January 2025. Primary outcome was safety and feasibility of robotics in emergency colorectal surgery. Secondary endpoints included perioperative and postoperative outcomes. Results Fifteen articles were included with a total of 46 robotic emergency colorectal surgical procedures. Most were performed in a tertiary centre with a da Vinci system. Most common procedures were robotic right hemicolectomy for colon cancer and sigmoid colectomy for acute diverticulitis. Mean operating time for robotic right hemicolectomy was 134 min for benign cases and 241 ± 7 min for malignant cases; robotic sigmoid colectomy showed a mean operating time of 171 ± 3 min. No intraoperative complications were recorded. One case required conversion. Intracorporeal anastomosis was performed in most cases (n = 13). Mean length of stay was 5 days. No Clavien-Dindo grade ≥ 3 complications, reoperation or readmission were reported. Five complete mesocolic excisions (CMEs) were performed. Pathology outcomes were available for four CMEs: showing R0 resection with a mean lymph node harvest of 54 ± 13. In four CMEs, the involved team included an on-call robotic colorectal surgeon and an experience theatre team including experienced anaesthetist in robotic procedures. Conclusions Robotics in emergency settings is feasible and safe but requires additional training and dedicated teams for optimal outcomes.

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Robotic surgery in colorectal emergencies: a systematic review of current evidence

World Journal of Emergency Surgery https://doi.org/10.1186/s13017-026-00685-z Article in Press Robotic surgery in colorectal emergencies: a systematic review of current evidence Accepted: 19 February 2026 Serena Curia, Christophe Taoum, Guglielmo Niccolò Piozzi, Diana Ronconi Di Giuseppe, Abhijeet Beniwal, Sentilnathan Subramaniam, Fausto Catena, Micaela Piccoli & Jim S. Khan Cite this article as: Curia S., Taoum C., Piozzi G.N. et al. Robotic surgery in colorectal emergencies: a systematic review of current evidence. World J Emerg Surg (2026). https://doi. org/10.1186/s13017-026-00685-z We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply. Received: 16 December 2025 A E R P S S If this paper is publishing under a Transparent Peer Review model then Peer Review reports will publish with the final article. I T R E L C IN © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. ACCEPTED ARTICLEMANUSCRIPT IN PRESS Title Robotic Surgery in Colorectal Emergencies: A Systematic Review of Current Evidence Short title Robotic Emergency Colorectal Surgery Authors Serena Curia1,2, Christophe Taoum1,3, Guglielmo Niccolò Piozzi1,4, Diana S S E Ronconi Di Giuseppe1,5, Abhijeet Beniwal1,6, Sentilnathan Subramaniam1,7, Fausto Catena8, Micaela Piccoli2, Jim S. Khan1,4 IN PR 1. Department of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth E L C Hospitals University NHS Trust, Portsmouth, UK I T AR 2. Department of General, Emergency Surgery and New Technologies, Baggiovara General Hospital, Azienda Ospedaliero Universitaria di Modena, Modena, Italy 3. Department of Surgical Oncology, Montpellier Cancer Institute (Institut du Cancer de Montpellier, ICM), Montpellier, France 4. Faculty of Science and Health, University of Portsmouth, Portsmouth, UK 5. Department of Surgery, Alma Mater Studiorum, University of Bologna, Bologna, Italy 6. Colorectal Surgery, St. Mark's Hospital at Central Middlesex Hospital, London, UK ACCEPTED ARTICLEMANUSCRIPT IN PRESS 7. Colorectal Surgery Unit, Department of General Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia 8. Department of General, Emergency, and Trauma Surgery, “M. Bufalini” Hospital, Cesena, Italy Corresponding author Prof. Jim S Khan MD PhD Address: Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth, PO6 3LY, United Kingdom S S E Email: Phone: +44 2392286000 Authors’ ORCID E L C IN PR I T AR - Serena Curia 0009-0005-6339-4574 - Christophe Taoum 0000-0002-7401-331X - Guglielmo Niccolò Piozzi 0000-0001-6667-9202 - Diana Ronconi Di Giuseppe 0000-0002-5533-4548 - Abhijeet Beniwal 0000-0001-7184-273X - Sentilnathan Subramaniam 0000-0002-9619-5054 - Fausto Catena 0000-0001-6828-9339 - Micaela Piccoli 0000-0003-0930-6770 - Jim S Khan 0000-0002-3031-4495 ACCEPTED ARTICLEMANUSCRIPT IN PRESS Abstract S S E Background: Although laparoscopy continues to be the predominant minimally PR invasive approach in most emergency settings, the advantages of robotics, well IN established in elective surgery, are currently being explored in selected E L C scenarios and specialized centres. I T AR Methods: A systematic review was conducted using PubMed, Cochrane Library and Scopus databases until January 2025. Primary outcome was safety and feasibility of robotics in emergency colorectal surgery. Secondary endpoints included perioperative and postoperative outcomes. Results: Fifteen articles were included with a total of 46 robotic emergency colorectal surgical procedures. Most were performed in a tertiary centre with a da Vinci system. Most common procedures were robotic right hemicolectomy for colon cancer and sigmoid colectomy for acute diverticulitis. Mean operating time for robotic right hemicolectomy was 134 minutes for benign cases and 241±7 minutes for malignant cases; robotic sigmoid colectomy showed a mean operating time of 171±3 minutes. No intraoperative complications were ACCEPTED ARTICLEMANUSCRIPT IN PRESS recorded. One case required conversion. Intracorporeal anastomosis was performed in most cases (n=13). Mean length of stay was 5 days. No ClavienDindo grade ≥ 3 complications, reoperation or readmission were reported. Five complete mesocolic excisions (CMEs) were performed. Pathology outcomes were available for four CMEs: showing R0 resection with a mean lymph node harvest of 54±13. In four CMEs, the involved team included an on-call robotic colorectal surgeon and an experience theatre team including experienced anaesthetist in robotic procedures. Conclusions: Robotics in emergency settings is feasible and safe but requires additional training and dedicated teams for optimal outcomes. Keywords: robotic, emergency PR surgery, IN S S E colorectal surgery, colorectal emergencies, colorectal cancer, diverticular disease. Introduction E L C I T AR Robotic approach is widely used worldwide across various surgical specialties, primarily for elective procedures. Globally, around 17 million robotic procedures have been performed using the Intuitive Surgical (Sunnyvale, CA, USA) robotic systems alone[1]. Laparoscopy has been widely adopted for emergency cases due to better short-term outcomes (reduced postoperative pain, shorter length of stay (LOS), lower risk of surgical site infection and overall complications, and decreased blood loss) than traditional open surgery. There are limited reports regarding the use of robotic surgery in emergencies. Lately, the World Society of Emergency Surgery (WSES) position paper has suggested that the emergency setting should not be considered as a ACCEPTED ARTICLEMANUSCRIPT IN PRESS contraindication for robotic surgery provided that an adequately trained team is available [2]. Pedraza et al.[3] described the first robotic emergency surgery in 2012. Since then, robotics has been adopted in emergency settings at referral cen (...truncated)


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Serena Curia, Christophe Taoum, Guglielmo Niccolò Piozzi, Diana Ronconi Di Giuseppe, Abhijeet Beniwal, Sentilnathan Subramaniam, Fausto Catena, Micaela Piccoli, Jim S. Khan. Robotic surgery in colorectal emergencies: a systematic review of current evidence, 2026, DOI: 10.1186/s13017-026-00685-z