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Genova et al. Mini-invasive Surg 2020;4:2 I http://dx.doi.org/10.20517/2574-1225.2019.30 Page 7 of 8

of which are represented by time of robotic setting, lack of both tactile sensation and tension feedback, and
[35]
high costs .

Robot docking and collisions among instruments partially explain the longer operating time frequently
reported for robotic surgery, but an experienced team may overcome this limitation, as can the
implementation of the latest technological innovations. The latter might also allow overcoming the absence
of tactile feedback of robotic systems, currently partially arranged by means of the ameliorated view they
[35]
provide .

For what concerns high costs, it can to be remarked that the implementation of conventional laparoscopy
was also very expensive at the beginning, but it provided a number of advantages in terms of postoperative
outcomes, which justified its spread. Clearly, the implementation of robotic surgery is more expensive, but
[35]
the evaluation of eventual clear benefits for patients and surgeons could motivate its use as well .
CONCLUSION
The implementation of robotic technology in general surgery represented the inevitable outlet of an
astonishing technological development. It has proved to be feasible and safe, with several operating
advantages for surgeons. However, clear advantages in terms of patient outcomes have not yet been
demonstrated after the implementation of robotic systems in colorectal surgery.

To evaluate the overall impact of robotic technology in colorectal surgery, further studies with high levels
of evidence are necessary, as well as those implementing the new robotic technologies already appearing in
operating theatres.

DECLARATIONS
Authors’ contributions
Conception: Genova P, Pantuso G, de’Angelis N
Literature review: Genova P, Pantuso G, Abdalla S, Memeo R, Gaiani F, Gavriilidis P, de’Angelis N
Writing: Genova P (Genova P and Gavriilidis P for the chapter “Ancient times: automata”)
Revision: Genova P, Pantuso G, Abdalla S, Memeo R, Gaiani F, Gavriilidis P, de’Angelis N

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.