“机器人”经自然腔道取标本手术（NOSES）是结直肠肿瘤外科治疗的重要组成部分。其结合“机器人”平台和结直肠肿瘤NOSES的优势，成为了结直肠外科医生广泛关注的术式。为此，中国医师协会结直肠肿瘤专业委员会NOSES学组，中国医师协会结直肠肿瘤专业委员会机器人手术学组于2022年制定了首部《“机器人”结直肠肿瘤经自然腔道取标本手术专家共识》，对推广规范“机器人”结直肠肿瘤NOSES起到了积极作用。广大结直肠外科医生经过3年的实践与总结，基于新的拓展和临床证据，再次修订共识。本次主要修订内容包括：调整R-CRC-NOSES Ⅵ和R-CRC-NOSESⅦ的手术体位；新增R-CRC-NOSES Ⅷ B法和C法；完善R-CRC-NOSES Ⅸ和 R-CRC-NOSES Ⅹ的消化道重建方式；新增并发症：结直肠残端血运障碍。通过修订《“机器人”结直肠肿瘤经自然腔道取标本手术专家共识》，本共识将引导“机器人”结直肠肿瘤NOSES更加科学规范地开展，这对我国“机器人”结直肠肿瘤NOSES的长远发展具有重要意义。

Robotic Natural Orifice Specimen Extraction Surgery （NOSES） is a vital component in the surgical management of colorectal tumors. By combining the strengths of the robotic platform and colorectal tumor NOSES， this technique has become a surgical approach that is attracting widespread attention among colorectal surgeons. In 2022， The Group of NOSES， Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association， The Group of Robotic Surgery， Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association developed the first “Expert Consensus on Robotic Natural Orifice Specimen Extraction Surgery for Colorectal neoplasm”， which has played a positive role in promoting standardized robotic colorectal tumor NOSES procedures. After three years of practice and summarization， a large number of colorectal surgeons have revised the consensus based on new developments and clinical evidence. The main revisions include: adjusted surgical positioning for R-CRC-NOSES Ⅵ/Ⅶ；new methodologies （B/C） for R-CRC-NOSES Ⅷ； optimized digestive tract reconstruction in R-CRC-NOSESⅨ/Ⅹ； and the addition of “poor blood supply to the colorectal stump” as a defined complication. This update aims to enhance scientific rigor and standardization in robotic NOSES， fostering its sustainable development in China's surgical landscape.