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Table 2. Robotic surgery for rectal cancer
Group Sample Level of
Ref. Study type Randomization Follow up Questionnaires Main findings
studied size evidence
D’Annibale et al. [29] , Retrospective No Robot 60 men 12 months IPSS, IIEF -Both robot and lap had 3
2013 single vs. Lap (30 decreased urinary func-
center TME Robot, tion at 1 month and was
30 Lap) restored by 12 months
-Robot had better sexual
function at 12 months
compared to lap
Kim et al. [30] , 2012 Prospective No Robot 69 (30 12 months IPSS, IIEF -Robot recovered urinary 2b
single vs. Lap Robot, function at 3 months com-
center TME 39 Lap) pared to 6 months in lap
-Robot recovered sexual
function at 6 months com-
pared to 12 months in lap
[31]
Park et al. , 2013 Retrospective No Robot 29 men 6 months Wexner, IPSS, IIEF -Robot had better sexual 3
single vs. Lap (14 function at 6 months com-
center TME Robot, 15 pared to lap
(with Lap) -No difference in fecal
ISR) incontinence and urinary
function
Park et al. [32] , 2014 Retrospective No Robot 64 (32 12 months IPSS, IIEF -Robot had better sexual 3
single vs. Lap Robot, function at 6 months but
center (case TME 32 Lap) both equal at 12 months
matched) compared to lap
-No difference in urinary
function
Kamali et al. [34] , Prospective No Robot 36 (18 12 months EORTC QLQ- -No difference in global 2b
2017 single vs. Lap Robot, 18 CR30, QLQ-CR29 health
center TME Lap) -Robot had better social
function, insomnia scores,
pain scores compared to
lap
-Robot had better impo-
tence scores compared to
lap
Kim et al. [36] , 2014 Retrospective No Robot 222 (108 12 months FISI, Lawson, VAS -Robot had better fecal 3
single vs. Open Robot, incontinence scores com-
center TME 114 pared to open
with ISR Open) -Robot had better sexual
function compared to
open
Kim et al. [35] , 2018 Prospective No Robotic 260 (130 12 months EORTC QLQ-C30, -Robot had better emo- 2b
single vs. Lap Robot, IPSS, IIEF tional and social function
center TME 130 Lap) compared to lap
-Robot had better symp-
toms of fatigue, insom-
nia, and financial issues
compared to lap
-Robot had better sexual
function compared to lap
-Robot had earlier return
of social function com-
pared to lap
Jayne et al. [37] , Prospective Yes Robot 471 (237 6 months IPSS, IIEF, FSFI -No difference in overall 1
2017 multicenter vs. Lap Rob, 234 QOL at 6 months
TME Lap)

Lap: laparoscopic; TME: total mesorectal excision; ISR: intersphincteric resection; QOL: quality of life; SF-36: short form general health
survey of 36 questions, EORTC QLQ-C30: European organization for research and treatment of cancer quality of life questionnaire,
30 cancer non-specific questions; EORTC QLQ-CR38: European organization for research and treatment of cancer quality of life
questionnaire, 38 colorectal cancer specific questions; IPSS: International Prostatic Symptom Score; IIEF: International Index of Erectile
Function; FSFI: Female Sexual Function Index; ICIQ-MLUTS: International consultation on incontinence male lower urinary tract
symptoms; ICIQ-FLUTS: International consultation on incontinence female lower urinary tract symptoms; FISI: Fecal Incontinence
Severity Index; VAS: visual analogue scale; Wexner: Wexner Fecal Incontinence Score; Level of evidence: 1: randomized controlled trial;
2a: randomized prospective cohort study; 2b: nonrandomized prospective cohort study; 3: retrospective cohort study; 4: case series

5D), EORTC QLQ-C30, and QLQ-CR29 were completed by patients pre-operatively and at 6, 12, 26, and 52
weeks after surgery. Quality of life diminished at 6 and 12 weeks after TEM compared to baseline (P < 0.05),