| Summary: | Introduction: Robotic systems are designed to address the limitations of laparoscopic surgery, leading to a growing interest in robotic rectal surgery. However, certain technical limitations associated with the previous systems (da Vinci S & Si) have arguably slowed down its wholesale adoption. The latest robotic platform, the da Vinci Xi, addresses these limitations. This study aims to examine the short-term surgical outcomes of 240 single-docking fully-robotic rectal cancer resections and compare the outcomes of cases performed with the da Vinci Xi vs Si systems. Materials and methods: All consecutive patients receiving robotic rectal cancer resections from three centres between 2013 and 2018 were identified from prospectively collated databases. The baseline characteristics and short-term surgical outcomes are presented and the da Vinci Xi vs Si system outcomes are analysed. Results: A total of 240 patients were identified (124 Si, 116 Xi). Median operation-time and length-of-stay were 260 minutes and 6 days respectively. Conversion and 30-day mortality rates were 0. The da Vinci Si vs Xi system analysis shows that operation-time was lower in the Si group (230 vs 300 min, p = 0.000) but length-of-stay, lymph node yield and circumferential resection margin favoured the Xi group (7 vs 5 days, p = 0.010; 17 vs 21, p = 0.000; 92.7% vs 99.1%, p = 0.020). Conclusion: Single-docking fully-robotic rectal cancer surgery is safe, feasible and can lead to good short-term outcomes, making it a good alternative to laparoscopic rectal cancer surgery. The new systems technological advances may result in better short-term outcomes but further larger scale observational studies are required if we are to reach such a conclusion. Keywords: Robotic surgery, Rectal cancer surgery, da Vinci Xi, da Vinci Si
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