Evidence for robotic surgery in oncological visceral surgery

The superiority of minimally invasive operative methods compared to open surgery with respect to various parameters of short-term outcome with adequate oncological long-term results has already been confirmed for many tumor entities in high-quality studies. The continuously expanding robotic surgery offers certain additional benefits in minimally invasive oncological visceral surgery, such as a high-resolution stable 3-dimensional view, optimal freedom of movement in situ, elimination of natural tremor and better ergonomics. This article evaluates whether these postulated advantages are reflected in an improvement of the short-term perioperative and long-term oncological results compared to conventional minimally invasive surgery in oncological visceral surgery (rectum, colon, stomach, esophagus, pancreas, liver) according to the criteria of evidence-based medicine. With the exception of colorectal surgery, there are currently no randomized controlled studies comparing robotic to laparoscopic surgery in oncological visceral surgery. There is still aclear imbalance between the exponentially expanding application of robotic surgery and the existing lack of high-quality evidence. Further randomized controlled clinical trials urgently need to be performed especially considering the great technological development potential of robotic surgery.