Background: Surgery for rectal cancer has evolved, with the adoption of minimally invasive and robotic techniques. This study evaluates whether robotic surgery for rectal cancer produces an improvement in perioperative and oncological outcomes compared with open and laparoscopic surgery in a retrospective analysis. Methods: A single-center retrospective study included 212 patients with histologically confirmed rectal cancer treated between 2012 and 2021. The patients were grouped by surgical approach: robotic (RR, n = 62), laparoscopic (LR, n = 68), and open resection (OR, n = 82). The primary endpoints were total mesorectal excision (TME) quality, operative time, and hospital stay. The secondary endpoints included the lymph node yield, the conversion rate, and the 5-year survival outcomes (OS and DFS), analyzed via Kaplan–Meier curves and proportional hazards models. Results: The TME quality was high across the groups (RR: 91.9%, LR: 86.8%, OR: 95.1%). The median operative time was the longest in the RR group (304 min vs. 221–222 min in LR/OR). Robotic surgery resulted in shorter median hospital stays (10 (RR) vs. 14 (LR) vs. 14 (OR) days) and a lower conversion rate (3.2% vs. 14.7% in LR). The lymph node yield was highest in the LR group (27.9), followed by the RR (25.5) and OR (23.0) groups. Postoperative pneumonia was most common in the OR group (12.2%), and bladder dysfunction occurred only in the OR group (4.9%). The five-year OS and DFS did not differ notably between the groups. Conclusions: Robotic surgery offers advantages in short-term outcomes, including fewer complications, shorter hospitalization, and lower conversion rates, despite longer operative times. Its oncological efficacy is equal compared to those of laparoscopic and open surgery.

Background/Objectives: Robotic surgery offers an additional minimally invasive option for gastric gastrointestinal stromal tumor (GIST) resection, particularly in anatomically demanding locations. Evidence regarding its integration into routine surgical practice remains limited. This study evaluated the evolution of surgical approaches for primary localized gastric GIST following the introduction of an institutional robotic program. Methods: We retrospectively analyzed 44 consecutive patients who underwent curative-intent resection for primary localized gastric GIST at a tertiary referral center between July 2015 and June 2025. Surgical management and perioperative outcomes were described for an early era (2015–2021; n = 29) and a later era after the introduction of robotic surgery (2022–2025; n = 15). Results: Overall, 22 procedures were completed laparoscopically, six robotically, and 13 through a primary open approach; three laparoscopic procedures were converted to open surgery. In the later era, robotic surgery accounted for 40.0% of resections, and no conversions occurred. The proportion of completed minimally invasive resections was 62.1% in the early era and 66.7% in the later era. R0 resection was achieved in all patients, and no tumor rupture was documented. Median operative time was 73.5 min, median postoperative length of stay was 7.5 days, and major morbidity occurred in six patients (13.6%). One patient (2.3%) died from sepsis within 30 days after reoperation for a postoperative gastric suture-line leak. Conclusions: Following the introduction of robotic surgery, management of primary gastric GIST evolved toward a more diversified and individualized surgical strategy. Robotic surgery was incorporated as an additional minimally invasive option, while the overall proportion of completed minimally invasive resections remained stable. These findings represent an early institutional experience and do not establish equivalence or comparative superiority among surgical approaches.

Background/Objectives: Minimally invasive approaches are increasingly used in right colectomy for colon cancer; however, comparative data, including open, laparoscopic, and robotic techniques, remain limited, particularly regarding postoperative recovery and oncological outcomes. Methods: This retrospective monocentric study included 89 patients undergoing elective right colectomy for colon cancer between July 2018 and December 2022. Of these, 30 patients underwent open, 29 laparoscopic, and 30 robotic-assisted surgery. The primary endpoint was postoperative recovery, defined as the time to first bowel movement. Secondary endpoints included length of hospital stay, complete mesocolic excision (CME) quality, lymph node yield, C-reactive protein (CRP) on postoperative day one, operative time, overall survival (OS), and disease-free survival (DFS). Multivariable regression analyses were performed adjusting for age, sex, BMI, ASA score, UICC stage, and tumor size. Results: Time to first bowel movement was shorter after minimally invasive surgery (median robotic 3.5, laparoscopic 4 vs. open 5 days) and length of hospital stay was numerically shorter (mean 9.1 vs. 10.1 days). CME quality and lymph node yield did not differ significantly between the approaches, and postoperative day-one CRP was numerically lower after robotic (median 4.9 mg/dL) and laparoscopic (5.1 mg/dL) than after open surgery (7.1 mg/dL), without reaching statistical significance after adjustment. Operative time was significantly longer with minimally invasive surgery (robotic +50 min; laparoscopic +43 min vs. open; both p < 0.001). Disease-free (open 51.6%, laparoscopic 66.5%, robotic 66.9%) and overall survival did not differ significantly after adjustment (robotic HR 1.16; laparoscopic HR 1.01 vs. open). Conclusions: No statistically significant difference in surgical quality between the approaches was detected, while operative time was significantly longer after minimally invasive surgery. No statistically significant independent association between the surgical approach and postoperative recovery or three-year oncological outcomes was detected; given the limited precision of the estimates, clinically important differences cannot be excluded.

Background/Objectives: Unplanned inpatient admission after intended outpatient surgery is commonly regarded as failure of ambulatory management, although the clinical relevance of such admissions remains unclear. This study evaluated the causes, management, and short-term outcomes of unplanned inpatient admission after intended outpatient total extraperitoneal (TEP) inguinal hernia repair. Methods: This retrospective single-center study included all patients requiring unplanned inpatient admission after intended outpatient unilateral TEP repair between January 2022 and May 2025. Admission triggers, perioperative management, Clavien–Dindo complication severity, length of stay, need for invasive intervention, and 30-day outcomes were analyzed descriptively. Results: Among 153 intended outpatient TEP procedures, 45 patients (29.4%) required unplanned inpatient admission. The most frequent trigger was suspected intraoperative bleeding requiring observation (29/45, 64.4%), followed by technical or anatomical factors (6/45, 13.3%), cardiovascular events (4/45, 8.9%), other medical reasons (3/45, 6.7%), postoperative pain or nausea (2/45, 4.4%), and social or organizational reasons (1/45, 2.2%). Thirty-seven patients (82.2%) had no postoperative complication, six (13.3%) had Clavien–Dindo grade I–II complications, and two (4.4%) had grade III or higher complications requiring invasive intervention. Most patients were discharged on postoperative day 1 (35/45, 77.8%). No patient required blood transfusion, intensive care admission, or 30-day readmission. Conclusions: Unplanned inpatient admission occurred in 29.4% of intended outpatient TEP procedures, representing a relatively high admission rate for a planned outpatient pathway. Although most admissions were associated with precautionary monitoring rather than clinically relevant morbidity, invasive intervention was required in a small proportion of patients. The retrospective data do not allow individual admissions to be classified as avoidable; however, the findings suggest potential for pathway optimization through more standardized discharge assessment and formalized admission criteria. Prospective studies are required to determine whether such standardization can reduce unplanned inpatient stays while maintaining patient safety.