Robotics confers an advantage in right hemicolectomy with intracorporeal anastomosis when matched against conventional laparoscopy

J Robot Surg. 2018 Dec;12(4):647-653. doi: 10.1007/s11701-018-0793-6. Epub 2018 Feb 22.

Abstract

Comparisons between robotic and laparoscopic right hemicolectomy have been confounded by variations in operative technique. This study evaluates the two procedures after standardizing the intraoperative steps and perioperative management. Patients who underwent robotic right hemicolectomy with intracorporeal bowel anastomosis between July 2015 and June 2017 were matched with a laparoscopic group. Perioperative management was in accordance to an enhanced recovery protocol. Outcomes and histopathological data were compared. Thirty-two patients were included. Amongst the patients who did not undergo complete mesocolic excision, the median operative time did not differ between the two groups (p = 0.413). The robotic group recorded a statistically shorter time for intracorporeal anastomosis (13 vs 19 min, p = 0.024). Postoperative recovery and complication rates were similar, except for a greater lymph node harvest in the robotic group (41 vs 31, p = 0.038). Robotic surgery achieves short-term results comparable to existing conventional laparoscopy, notwithstanding the advantages of enhanced ergonomics.

Keywords: Intracorporeal anastomosis; Laparoscopic; Right hemicolectomy; Robotic; Xi.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Anastomosis, Surgical / methods
  • Clinical Protocols
  • Colectomy / adverse effects
  • Colectomy / methods*
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery
  • Female
  • Humans
  • Intestines / surgery
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Lymph Node Excision / methods
  • Male
  • Middle Aged
  • Operative Time
  • Perioperative Care
  • Postoperative Complications
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / methods*