The benefit of laparoscopic surgery for colorectal cancer has been demonstrated. However, inherent features of the laparoscopic procedure such as limited range of motion of the rigid instruments, amplification of tremor from the fulcrum effect, and unstable image from the hand-held camera add to the difficulty and limit its widespread application.
　　Robotic platform for colorectal surgery is an emerging technique. The incorporation of advantageous features such as dexterity from articulated instruments, intuitive ergonomics, fine motion scaling, tremor filtration, steady retraction for exposure provided by the extra robotic arm, and a stable surgeon-controlled camera with 3-dimensional high-definition imaging may help overcome the limitations of laparoscopic surgery.
　　Rectal cancer is accounting for around 30% of the total colorectal cancer incidence. It has long been technically challenging to perform laparoscopic total mesorectal excision (TME) for rectal cancer in the middle to lower position. Robotic platform may be a solution to overcome technical difficulty of laparoscopic approach. The conversion rate is a valuable item to assess the influence on early postoperative morbidity of rectal surgery. Evidence from meta-analysis demonstrated that the overall pooled conversion rate was significantly lower for patients who underwent robotic surgery.
　　From our experience, robotic surgery for patients with advanced rectal cancer undergoing nCRT is safe and feasible. Furthermore, although robotic procedure was performed in a relatively limited number of patients with more clinically advanced diseases, the results indicated that the perioperative outcomes of robotic surgery may be comparable to those of laparoscopic surgery.
　　Study also demonstrated that robotic platform provided favorable short-term clinical outcomes using high dissection and low ligation of the IMA technique and splenic flexure mobilization for rectal cancer after nCRT.
　　With the new Xi robotic system, robotic colorectal surgery was associated with improved outcomes, including shorter operation time, lower rate of diverting stoma, less blood loss, and faster postoperative recovery. These benefits may be attributed to its improved, more user-friendly design.
　　However, considering the extra financial and time expenses of the robotic procedure, this novel technology should be selectively applied; thus, additional efforts should be devoted toward searching for the specific subset of patients who may benefit from the robotic procedure.