Ischemia-reperfusion injury (IRI) remains a clinical challenge in liver surgery, trauma and transplantation, contributing to morbidity and mortality worldwide. Thus, its impact, not only on the liver itself but also on remote tissues, has been studied during the last years. Different natural anti-oxidant substances have been researched in animal models, implementing different times of ischemia, aiming to test new therapeutic interventions. A literature review has been conducted with two goals: (1) to identify different natural anti-oxidants studied in experimental models; and (2) to summarize the various times of ischemia employed. Scientific papers published in PubMed for the period 2000–2020 were searched and reviewed. More than 30 natural anti-oxidants have been tested. The time of ischemia ranged from 15 to 90 min with 60 min used most frequently, followed by 45 min. No studies were found with time exceeding 90 min. A significant number of research has been conducted on the use and protective effect of natural anti-oxidants in experimental animal models. Based on the published papers, 45–60 min seems to be the optimal duration of ischemia.

Background: Splenic flexure cancers represent a small but anatomically complex subset of colorectal malignancies, characterised by variable vascular supply and lymphatic drainage. This has led to ongoing uncertainty regarding the optimal extent of resection and level of vascular ligation. With increasing adoption of robotic surgery, a range of operative approaches has been described, although these remain inconsistently reported and poorly synthesised. Aim: We aimed to map operative heterogeneity in robotic splenic flexure cancer surgery, focusing on resection extent, vascular ligation, reconstruction strategy, and technical configuration. Methods: A structured scoping review was performed in accordance with PRISMA-ScR guidelines. MEDLINE (PubMed) and Embase (Ovid) were searched from inception to January 2026. Studies reporting robotic resection for primary splenic flexure colon cancer with extractable operative detail were included. Data were synthesised descriptively and grouped into three tiers based on study design: comparative cohorts, case series, and technical reports. Results: Sixteen studies comprising 97 robotic resections were included. Three were comparative cohort studies; two were case series, and eleven were single-case technical reports. Comparative studies consistently described a flexure-directed segmental resection with preservation of the inferior mesenteric artery and division of the left colic artery. In contrast, there was greater variability in management of the middle colic branches and inferior mesenteric vein. Reconstruction strategy differed across tiers, with extracorporeal anastomosis more commonly reported in comparative cohorts, while intracorporeal techniques were frequently described in technical series. Anastomotic configuration, specimen extraction, and use of indocyanine green fluorescence varied widely. Terminology relating to complete mesocolic excision and D2/D3 lymphadenectomy was inconsistent and often poorly defined. Conclusions: Robotic splenic flexure surgery shows broad agreement in overall resection strategy but considerable variability in vascular control, reconstruction, and technical execution. This likely reflects differences in reporting rather than clear differences in oncological intent. A more consistent and structured operative description is needed to allow meaningful comparison and to support the development of evidence-based approaches in this technically demanding area.