{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:32:12Z","timestamp":1790253132228,"version":"4.1.0"},"reference-count":40,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The potential role of robotic surgery in segmental colectomy for the treatment of splenic flexure and mid-transverse colon cancers remains underexplored. These sites are technically demanding because of the occurrence of vascular variability, the need for dual lymphatic drainage, and the close anatomical relationship to surrounding organs. This systematic review evaluated surgical strategies, anastomotic techniques, perioperative outcomes, and the oncological adequacy of robotic segmental colectomies in this context. Methods: The review followed the PRISMA guidelines (PROSPERO ID: CRD420251119736). Studies were eligible if they included \u22653 patients who were undergoing a robotic segmental colectomy for malignant tumors of the splenic flexure or mid-transverse colon. Data on patient demographics, operative details, complications, and oncological outcomes were extracted. The risk of bias was assessed using the Newcastle\u2013Ottawa Scale and ROBINS-I. Results: Five retrospective studies reporting on 74 patients were included. All the procedures involved a fully robotic approach. Vascular ligation was uniform for transverse tumors (middle colic vessels point of origin), but varied for splenic flexure lesions. Anastomotic reconstruction was extracorporeal stapled (55.4%), intracorporeal stapled (16.2%), or intracorporeal hand sewn (4.1%). Operative times were in the range of 157.5\u2013268 min; conversion occurred in 4.1% of cases. The overall morbidity was 16.2%, with anastomotic leaks in 5.4% of cases. No 30-day mortality was observed, and one reoperation was required. All patients achieved R0 resection, with a mean lymph node yield of 16.9. Only one recurrence was documented during the follow-up period. Conclusions: Robotic segmental colectomy for splenic flexure and mid-transverse colon malignancies is feasible and safe, achieving consistent perioperative and oncological outcomes. Larger multicenter prospective studies are needed to validate the oncological adequacy, standardize anastomotic strategies, and assess the cost effectiveness of the approach.<\/jats:p>","DOI":"10.3390\/jcm14207236","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T11:57:42Z","timestamp":1760529462000},"page":"7236","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Robotic Segmental Resection of the Splenic Flexure and Mid-Transverse Colon for Malignancy Treatment: A Systematic Review of Operative Techniques, Anastomotic Approaches, and Surgical and Oncological Outcomes"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8534-9823","authenticated-orcid":false,"given":"Alessia","family":"Fassari","sequence":"first","affiliation":[{"name":"Centre Hospitalier de Luxembourg, L-1210 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Iossa","sequence":"additional","affiliation":[{"name":"Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Micalizzi","sequence":"additional","affiliation":[{"name":"Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Lelli","sequence":"additional","affiliation":[{"name":"Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1547-401X","authenticated-orcid":false,"given":"Sara","family":"Giovampietro","sequence":"additional","affiliation":[{"name":"Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Rosso","sequence":"additional","affiliation":[{"name":"P\u00f4le Sant\u00e9 Sud, 72100 Le Mans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7121-2295","authenticated-orcid":false,"given":"Giuseppe","family":"Cavallaro","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1007\/s005950170169","article-title":"Surgical treatment and subsequent outcome of patients with carcinoma of the splenic flexure","volume":"31","author":"Nakagoe","year":"2001","journal-title":"Surg. 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