Other limitations of robotic surgery are like the selleck inhibitor large size of the robotic system, which necessitates additional manpower to set it up and creates new challenges for the anesthesia team and surgical assistants. Unfortunately, the high cost of the robotic equipment forbids its routine presence and use in most operating rooms across the globe. This calls for the development of smaller, less expensive and easy to operate robotic platforms, which are portable and flexible to use, as well as specific instruments for tasks in head and neck surgery. Besides the evidence of robotic feasibility and safety in head and neck surgery, postoperative outcomes regarding airway management and oropharyngeal function are comparable or better to traditional surgical approaches.

Although we did not explore the details concerning oncologic results, robot-assisted surgery showed a trend towards favorable cure and recurrence rates. This can be attributed to its capability to resect tumour en-bloc��a feature that is provided by the increased dexterity and 3D visualization of the robotic system. We believe that future studies comparing robotic techniques to Transoral Laser Microsurgery (TLM), open surgery and chemoradiotherapy are required to support these assertions. Reported studies are supportive of the feasibility and safety of robotic surgery in head and neck procedures and encourage its continuing use and exploration.

Laparoscopy has been widely proven to be a feasible, safe, and effective technique to perform colorectal resections [1, 2, 56�C61] leading to clinically relevant advantages in selected patients such as reduction of postoperative pain [1, 62] and complications, shortening hospital stay and improving recovery [1, 58, 63], wound healing [1, 64], and cosmesis [65, 66]. Moreover, minimally invasive surgery has facilitated the application of enhanced recovery programs in colorectal surgery [67�C69]. Long-term outcome of laparoscopic colonic resection for cancer is not different from what has been achieved by open surgery procedures [2]. Therefore, some authors suggest that laparoscopy should be the preferred technique to perform colectomy in patients suitable for this approach [1]. New trends have been developed in order to further reduce the impact of surgical procedure in patients undergoing colorectal resections.

Three main directions have been undertaken in specialized centres: SILS, which aims to the reduction of port number, NOTES, in which surgical instruments are inserted in hollow organs trough natural openings, and minilaparoscopic colorectal surgery, based on reduction of port size. SILS was first described by Piskun and Rajpal for cholecystectomy Brefeldin_A as early as 1999 [14]; this term currently identifies surgical procedures that provide the placement of one port having three or more working channels within the umbilicus.