Restorative resection in robot-assisted versus laparoscopic total mesorectal excision: systematic review and meta-analysis

The surgical treatment of rectal cancer is based on the principle of total mesorectal excision (TME). Owing to its technological advantages, robot-assisted total mesorectal excision (R-TME) is hypothesized to facilitate primary anastomosis more frequently than laparoscopic total mesorectal excision (L-TME). This systematic review and meta-analysis aimed to investigate whether R-TME is associated with a higher likelihood of restorative surgery compared with L-TME.

This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. The protocol was prospectively registered in PROSPERO, the international prospective register of systematic reviews (registration number: 1106767). PubMed/MEDLINE, Embase, the Web of Science, and the Cochrane Library were searched for studies from January 2010 to January 2026. Pooled ORs and mean differences were calculated using a random-effects model.