Long-Term Single-Surgeon Outcomes of 320 Robotic Colorectal Cancer Resections: Safety, Oncologic Reliability, and Cost-Effectiveness

Background: Robotic surgery is increasingly adopted for colorectal cancer, but long-term single-surgeon data are limited. This study assessed perioperative, oncologic and economic outcomes of a standardised robotic colorectal programme over 9 years. Methods: A retrospective cohort of 320 consecutive patients undergoing robotic resection for colorectal malignancy (2016–2025) was analysed. Procedures included right, left, transverse and rectal resections using the da Vinci Si/Xi system. Primary end points were conversion, major complications (Clavien–Dindo ≥ III), 30-day mortality and R0 resection. Secondary outcomes were operative time, length of stay (LOS), reoperation and model-based cost-effectiveness using the Quantify the Impact (QTI) tool. Results: Conversion occurred in 1.9%, anastomotic leak in 2.2% and mortality in 1%. R0 resection was 99.7%, median LOS 7 [5–10] days, and reoperation 2.5%. QTI estimated savings of €483 versus laparoscopy and €3181 versus open surgery. Conclusions: A standardised robotic colorectal programme achieved safe, reproducible and economically sustainable outcomes.