An analysis of feasibility of robotic colectomy: post hoc analysis of a phase III randomised controlled trial

Fleming, Christina; Celarier, Soline; Fernández, Benjamı́n; Cauvin, Thomas; Célérier, Bertrand; Denost, Quentin

doi:10.1007/s11701-022-01501-x

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…(distal) gastrectomy 606 (302 vs 304) 34–90 vs 40–90 33–52 vs 35–37 30–365 d –/NR 3 [ 34 – 36 ] Colectomy ∙ Cancer/benign colonic pathologies ∙ Right-sided colon cancer ∙ Robotic colectomy ∙ Robot-assisted right colectomy ∙ Lap. colectomy ∙ Lap.-assisted right colectomy 198 (78 vs 120) 20–93 vs 22–90 53–60 vs 49–54 NR/5 yrs – 2 [ 37 , 38 ] Rectal resection ∙ Middle/low rectal cancer ∙ Robotic abdominoperineal resection ∙ Robotic surgery for rectal cancer ∙ Lap. abdominoperineal resection ∙ Conventional lap.…”

Section: Resultsmentioning

confidence: 99%

“…Effectiveness & safety Effectiveness and safety outcomes were either not assessed, reported, or not statistically significantly different in both included RCTs [ 37 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…Perioperative events & resource use The two included studies reported statistically significant results favouring the control arms regarding the duration of surgery (IG: 195 ± 41.0 vs CG: 129.7 ± 43.2 min, p < 0.001 [ 37 ]; median [range] IG: 172 [107–353] vs CG: 145 [69–380] min, p = 0.005 [ 38 ]).…”

Section: Resultsmentioning

confidence: 99%

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Robot-assisted surgery in thoracic and visceral indications: an updated systematic review

Grössmann-Waniek,

Riegelnegg,

Gassner

et al. 2024

Surg Endosc

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Background In surgical advancements, robot-assisted surgery (RAS) holds several promises like shorter hospital stays, reduced complications, and improved technical capabilities over standard care. Despite extensive evidence, the actual patient benefits of RAS remain unclear. Thus, our systematic review aimed to assess the effectiveness and safety of RAS in visceral and thoracic surgery compared to laparoscopic or open surgery. Methods We performed a systematic literature search in two databases (Medline via Ovid and The Cochrane Library) in April 2023. The search was restricted to 14 predefined thoracic and visceral procedures and randomized controlled trials (RCTs). Synthesis of data on critical outcomes followed the Grading of Recommendations, Assessment, Development, and Evaluation methodology, and the risk of bias was evaluated using the Cochrane Collaboration’s Tool Version 1. Results For five out of 14 procedures, no evidence could be identified. A total of 20 RCTs and five follow-up publications met the inclusion criteria. Overall, most studies had either not reported or measured patient-relevant endpoints. The majority of outcomes showed comparable results between study groups. However, RAS demonstrated potential advantages in specific endpoints (e.g., blood loss), yet these findings relied on a limited number of low-quality studies. Statistically significant RAS benefits were also noted in some outcomes for certain indications—recurrence, quality of life, transfusions, and hospitalisation. Safety outcomes were improved for patients undergoing robot-assisted gastrectomy, as well as rectal and liver resection. Regarding operation time, results were contradicting. Conclusion In summary, conclusive assertions on RAS superiority are impeded by inconsistent and insufficient low-quality evidence across various outcomes and procedures. While RAS may offer potential advantages in some surgical areas, healthcare decisions should also take into account the limited quality of evidence, financial implications, and environmental factors. Furthermore, considerations should extend to the ergonomic aspects for maintaining a healthy surgical environment. Graphical abstract

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Section: Resultsmentioning

confidence: 99%

“…Effectiveness & safety Effectiveness and safety outcomes were either not assessed, reported, or not statistically significantly different in both included RCTs [ 37 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Robot-assisted surgery in thoracic and visceral indications: an updated systematic review

Grössmann-Waniek,

Riegelnegg,

Gassner

et al. 2024

Surg Endosc

View full text Add to dashboard Cite

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“…Conversion rates, in particular, are predictive of longer hospital stays, higher complication rates, and higher recurrence rates. For example, the ROLARR trial demonstrated that conversion rates were lower than with laparoscopic surgery, especially in obese and male patients [3,4,17] . Similarly, another randomized controlled study demonstrated that robotic surgery decreased length of stays and conversion rates compared to laparoscopic surgery [18] .…”

Section: Short-term Outcomesmentioning

confidence: 99%

Development of robotic surgical devices and its application in colorectal surgery

Erozkan,

Gorgun

2023

Mini-invasive Surg

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Due to greater accessibility, robotic technology is becoming increasingly common in a wide range of general surgical procedures. In relation to traditional laparoscopic techniques, robotic surgery has four significant advantages: greater accessibility, visibility, accuracy, and comfortability. For example, robotic surgery is particularly beneficial for procedures in hard-to-reach areas (e.g., pelvis, rectum, and endoluminal areas) because it offers a greater range of motion and precision. In addition, surgical visibility and accuracy can be improved by providing 3D and magnified visualization of the surgical field. Robotic systems are also designed for surgeons’ comfort, allowing the operator to sit while working. For these reasons, robotic surgery is preferable for colorectal and other abdominal surgical procedures. As interest in minimally invasive surgery increases, so does the need to develop new approaches and procedures in colorectal surgery. While robotic surgery has great potential for improving outcomes, there may be disadvantages over traditional laparoscopic and open surgical procedures. For example, possible disadvantages include increased maintenance, training, and cost. This review discusses the evolution of robot-assisted surgery with respect to short-term and long-term outcomes. The development of robotic surgical devices, the new devices entering the market, and the possible future directions of robotic surgery will also be discussed.

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Association of robotic surgery with early discharge, readmission, and complications in elective colectomy: an analysis of NSQIP data from 2012 to 2021

Hsu,

Zion,

Powell

et al. 2024

J Robotic Surg

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An analysis of feasibility of robotic colectomy: post hoc analysis of a phase III randomised controlled trial

Cited by 4 publications

References 20 publications

Robot-assisted surgery in thoracic and visceral indications: an updated systematic review

Robot-assisted surgery in thoracic and visceral indications: an updated systematic review

Development of robotic surgical devices and its application in colorectal surgery

Association of robotic surgery with early discharge, readmission, and complications in elective colectomy: an analysis of NSQIP data from 2012 to 2021

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