Peter E Miller1, Haisar Dao2, Nivedh Paluvoi2, Matthew Bailey3, David Margolin4, Nishit Shah5, H D Vargas4. 1. Department of Surgery, Alpert Medical School, Brown University, Rhode Island Hospital, Providence, RI. Electronic address: Peter.Miller@lifespan.org. 2. Department of Surgery, Saint Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA. 3. The Lexington Clinic, Lexington, KY. 4. Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, LA. 5. Department of Surgery, Alpert Medical School, Brown University, Rhode Island Hospital, Providence, RI.
Abstract
BACKGROUND: The robotic platform has been used increasingly to perform colorectal surgery. The benefits of robotic colectomy when compared with laparoscopic colectomy have not been definitively established. STUDY DESIGN: A retrospective review of the NSQIP database was performed on patients undergoing elective laparoscopic or robotic colectomy in 2013. Demographic characteristics, length of stay, operative time, and 30-day postoperative complications were compared between the 2 groups. RESULTS: Of the 17,774 colectomies performed during the study period, 11,267 (63.4%) were performed laparoscopically and 653 (3.7%) were performed robotically. In comparison with laparoscopic colectomy, robotic colectomy was associated with increased operative time (233 vs 180 minutes; p < 0.01) and decreased length of stay (5.04 vs 6.06 days; p < 0.01). There was no significant difference with respect to mortality (0.2% vs 0.4%; p < 0.312), anastomotic leak (3.4% vs 3.1%; p = 0.715), reoperation (4.9% vs 4.0%; p = 0.27), conversion (10.3% vs 12.2%; p = 0.13), or readmission (9.3% vs 8.7%; p = 0.593) rates. The differences in length of stay and operative time persisted in the right colectomy and left colectomy/sigmoid resection subgroup analysis with no difference in conversion rates. CONCLUSIONS: In this head-to-head comparison of laparoscopic colectomy and robotic colectomy, the majority of postoperative outcomes were equivalent, except for an increase in operative time and shorter length of stay in the robotic group. Robotic colectomy appears to be a safe option for minimally invasive colectomy, but additional studies are needed to elucidate whether it is cost-effective when compared with laparoscopic colectomy.
BACKGROUND: The robotic platform has been used increasingly to perform colorectal surgery. The benefits of robotic colectomy when compared with laparoscopic colectomy have not been definitively established. STUDY DESIGN: A retrospective review of the NSQIP database was performed on patients undergoing elective laparoscopic or robotic colectomy in 2013. Demographic characteristics, length of stay, operative time, and 30-day postoperative complications were compared between the 2 groups. RESULTS: Of the 17,774 colectomies performed during the study period, 11,267 (63.4%) were performed laparoscopically and 653 (3.7%) were performed robotically. In comparison with laparoscopic colectomy, robotic colectomy was associated with increased operative time (233 vs 180 minutes; p < 0.01) and decreased length of stay (5.04 vs 6.06 days; p < 0.01). There was no significant difference with respect to mortality (0.2% vs 0.4%; p < 0.312), anastomotic leak (3.4% vs 3.1%; p = 0.715), reoperation (4.9% vs 4.0%; p = 0.27), conversion (10.3% vs 12.2%; p = 0.13), or readmission (9.3% vs 8.7%; p = 0.593) rates. The differences in length of stay and operative time persisted in the right colectomy and left colectomy/sigmoid resection subgroup analysis with no difference in conversion rates. CONCLUSIONS: In this head-to-head comparison of laparoscopic colectomy and robotic colectomy, the majority of postoperative outcomes were equivalent, except for an increase in operative time and shorter length of stay in the robotic group. Robotic colectomy appears to be a safe option for minimally invasive colectomy, but additional studies are needed to elucidate whether it is cost-effective when compared with laparoscopic colectomy.
Authors: Mohammed H Al-Temimi; Bindupriya Chandrasekaran; Johan Agapian; Walter R Peters; Katrina O Wells Journal: Int J Colorectal Dis Date: 2019-06-23 Impact factor: 2.571
Authors: Fabio Bagante; Gaya Spolverato; Steven M Strasberg; Faiz Gani; Vanessa Thompson; Bruce L Hall; David J Bentrem; Henry A Pitt; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2016-07-13 Impact factor: 3.452
Authors: Gabriela Batista Rodríguez; Andrea Balla; Santiago Corradetti; Carmen Martinez; Pilar Hernández; Jesús Bollo; Eduard M Targarona Journal: Int J Colorectal Dis Date: 2018-04-06 Impact factor: 2.571