Abstract:Complex rectal cancer often requires extended multivisceral resection beyond the total mesorectal excision plane or lateral lymph node dissection (LLND) beyond the conventional range. Owing to the deep pelvic location, limited operating space, and complex local anatomy, conventional open or laparoscopic surgery is associated with restricted visualization, technical difficulty, and increased surgical risk. With the advancement of robot-assisted surgical technology, its high-definition three-dimensional vision, articulated robotic arms with multiple degrees of freedom, and ergonomic improvements effectively overcome the limitations of traditional laparoscopy, allowing precise manipulation in narrow pelvic spaces. These advantages have made robotic surgery increasingly valuable in complex rectal cancer procedures such as LLND and multivisceral resection. This review summarizes recent literature and the authors' clinical experience to discuss the feasibility, advantages, and limitations of robotic-assisted rectal cancer surgery.