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Review
. 2025 Aug;21(4):e70098.
doi: 10.1002/rcs.70098.

Fully Robotic Total Colectomy in High-Risk Patients and Review of Literature

Igor Monsellato  1 , Teresa Gatto  1 , Maria Antonietta Alagia  1 , Federico Sangiuolo  1 , Marco Palucci  1 , Celeste Del Basso  1 , Martina Girardi  1 , Irene Gandini  1 , Gabriela Del Angel-Millan  1 , Marco Lodin  1 , Fabio Giannone  1 , Gianluca Cassese  1   2 , Fabrizio Panaro  1   2
Affiliations
Review

Fully Robotic Total Colectomy in High-Risk Patients and Review of Literature

Igor Monsellato et al. Int J Med Robot. 2025 Aug.

Abstract

Background: Robotic total colectomy is a valuable approach for managing complex colorectal diseases. Its role in high-risk patients, especially those with significant comorbidities or synchronous malignancy, remains underreported.

Methods: Two high-risk male patients with familial adenomatous polyposis (FAP), one with synchronous colon cancer, underwent fully robotic total colectomy with intracorporeal ileo-pouch-rectal anastomosis and loop ileostomy using the da Vinci Xi system in 2024. A focused review of the recent literature on robotic colectomy was also conducted.

Results: The mean age was 68 years, and mean BMI was 33.05 kg/m2. One patient had cirrhosis and obesity; the other had severe obesity and psychiatric comorbidity. Both procedures were completed without conversions or complications. Mean console time was 315 min, and mean hospital stay was 11 days.

Conclusions: Fully robotic total colectomy is feasible and safe in high-risk patients. These findings support its expanded role in minimally invasive colorectal surgery.

Keywords: colorectal cancer; familial adenomatous polyposis; indocyanine green fluorescence imaging; minimally invasive surgery; robotic total colectomy.

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