Topic: Functional Preservation in Minimally Invasive Colorectal Surgery: Techniques, Outcomes, and Innovations

Minimally invasive colorectal surgery is no longer judged only by incision size, blood loss, or length of stay. For many patients, success also means preserving continence, avoiding a permanent stoma, maintaining urinary and sexual function, and returning to an acceptable quality of life without compromising cancer control.

Laparoscopic and robotic approaches offer magnified visualization and improved access to the narrow pelvis, which may support precise mesorectal dissection and pelvic autonomic nerve preservation. Yet functional morbidity remains common, particularly low anterior resection syndrome after sphincter-saving rectal surgery. Organ-preservation strategies, including response-based surveillance and transanal local excision, also raise important questions about patient selection, follow-up, salvage treatment, and long-term function.

This Special Issue will examine techniques and technologies that may improve meaningful functional outcomes, including refined anastomotic reconstruction, transanal minimally invasive surgery, natural orifice specimen extraction, fluorescence guidance, single-port and next-generation robotic platforms, navigation, and artificial intelligence. We welcome clinical studies, technical reports, reviews, and perspectives that evaluate functional preservation together with oncological safety and patient-reported outcomes.

Topics of interest include, but are not limited to:

● Laparoscopic and robotic approaches to colon and rectal surgery;

● Organ preservation after neoadjuvant treatment, including watch-and-wait and local excision;

● Sphincter-preserving surgery for low and very low rectal cancer;

● Anastomotic reconstruction, selective diversion, and stoma-free survival;

● Pelvic autonomic nerve preservation and urinary and sexual outcomes;

● Prevention, assessment, and management of low anterior resection syndrome;

● Transanal minimally invasive surgery and related local excision techniques;

● Fluorescence-guided surgery, navigation, and artificial intelligence;

● Single-port and next-generation robotic platforms and techniques;

● Patient-reported outcomes, quality of life, and shared decision-making.