Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial.

Feng Q, Yuan W, Li PT, Tang B, Jia B, Zhou Y et al, for the REAL Study Group.

Some 1240 patients were included in the study, and 1171 included in the analysis. Rates of positive resection margin were: robotic 4 per cent, laparoscopic 7.2 per cent, P=0.023. Complete resection rates were similarly improved: 95.4 versus 91.8 per cent, respectively. Relative postoperative complication rates were 16.2  and 23.1 per cent, P=0.003. Hospital stay was also shorter: 7 versus 8 days, P=0.0001.

Comment: The first real evidence that the robot beats the laparoscope. But what are the long term results, and are the benefits worth the increased costs?