Surgical Management of Colorectal Cancer with the Da Vinci Xi Robotic System: A Single-Center Experience

Background. Surgery is the primary treatment modality for non-metastatic colorectal cancer (CRC), required in approximately 88% of cases, either as monotherapy or in combination with adjunct therapies. Precise colon resection is essential for optimizing both immediate and long-term outcomes. Several clinical studies have shown that robotic technology reduces intraoperative blood loss and conversion rates. Objective. To evaluate the early experience with the Da Vinci Xi robotic system for the treatment of CRC at Oncology Centre No. 1, Moscow City Clinical Hospital named after S.S. Yudin. Materials and methods. Treatment outcomes were retrospectively analyzed in 157 patients with localized CRC who underwent robotic surgery between August 2024 and December 2025. Results. Conversion to open surgery was necessary in two cases due to large tumor size and injury to the main artery. The duration of surgery ranged from 110 to 767 minutes, with a median of 265 minutes. Intraoperative blood loss ranged from 50 to 400 mL, with a median of 50 mL. Postoperative hospital stay ranged from 4 to 48 days, with a median of 7 days. A total of 67 patients (43%) required transfer to the intensive care unit after surgery. Conclusion. The initial experience at this center demonstrates the feasibility of rapid and effective adoption of the Da Vinci Xi robotic system in colorectal surgery, with acceptable immediate outcomes for localized CRC, provided the operator has sufficient experience in minimally invasive CRC surgery.