Abstract
<sec> <title>BACKGROUND</title> <p>Colonic diseases frequently require minimally invasive procedures. Laparoscopy has become the standard minimally invasive approach but is limited by 2D vision, magnified hand tremors and poor ergonomics. Robotic surgery was introduced to overcome these shortcomings, yet it suffers from longer operation time and higher costs. Multiple meta-analyses comparing the two techniques have yielded inconsistent perioperative and oncological findings, with narrow disease coverage and limited generalizability. This overview synthesizes current evidence to inform clinical decision-making.</p> </sec> <sec> <title>OBJECTIVE</title> <p>The aim of this overview of systematic reviews was to systematically evaluate the advantages and perioperative outcomes of robotic surgery compared with laparoscopic surgery for colonic diseases, and to provide evidence-based guidance for clinical decision-making.</p> </sec> <sec> <title>METHODS</title> <p>PubMed, Embase, and Web of Science were searched from inception to January 1, 2026 for systematic reviews and meta-analyses comparing robotic and laparoscopic colonic surgery. After screening against predefined inclusion and exclusion criteria, the PRISMA 2020, AMSTAR 2.0, and GRADE tools were used to assess the reporting quality, methodological quality, and level of evidence of the included reviews. Outcomes including conversion to open surgery, operative time, blood loss, complications, length of hospital stay, oncological outcomes, medical costs, and mortality were analyzed.This overview was registered on PROSPERO (CRD420261415344).</p> </sec> <sec> <title>RESULTS</title> <p>Twenty-four English-language meta-analyses were included. Quality assessment showed that most reviews had some reporting deficiencies; none provided a list of excluded studies or funding information. The overall evidence was predominantly low to very low. Outcome analysis indicated that robotic surgery was associated with lower conversion rate to open surgery, less intraoperative blood loss, shorter postoperative hospital stay, and shorter time to first flatus. However, operative time was significantly longer for robotic surgery. No significant differences were found between the two groups for anastomotic leakage, incisional infection, postoperative ileus, number of lymph nodes harvested, or all-cause mortality in most studies. Robotic surgery incurred higher medical costs.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>Robotic colonic surgery offers superior minimally invasive benefits and better postoperative recovery, making it suitable for patients with technically demanding conditions. Laparoscopic surgery has shorter operative time and lower costs, making it more appropriate for routine colonic lesions and resource-limited settings. The overall quality of the available evidence is limited, and more high-quality, large-sample randomized controlled trials are needed.</p> </sec>