Colorectal robotic surgery: INCA's experience

Abstract

Introduction Minimally invasive surgery has revolutionized surgical management in the treatment of colorectal neoplasms, reducing morbidity and mortality, hospitalization, inactivity time and minimizing cost, as well as providing adequate oncological results when compared to the conventional approach. Robotic surgery, with Da Vinci Platform, emerges as a step ahead for its potentials. The objective of this article is to report the single institutional experience with the use of Da Vinci Platform in robotic colorectal surgeries performed at a reference center in oncological surgery in Brazil. Materials and methods A retrospective cohort study was conducted based on the prospective database of patients from the institution submitted to robotic surgery for treatment of colorectal cancer from July 2012 to September 2017. Clinical and surgical variables were analyzed as predictors of morbidity and mortality. Results A total of 117 patients underwent robotic surgery. The complications related to surgery occurred in 33 patients (28%), the most frequent being anastomotic fistula and surgical wound infection, which corresponded to 11% and 3%, respectively. Conversion rate was 1.7%. Median length of stay was 5 days. The only variable associated with increase of complications and death risk was BMI >30, with p -value of 0.038 and 0.027, respectively. Conclusion Robotic surgery is safe and feasible for approaching colorectal cancer surgeries, presenting satisfactory results regarding length of hospital stay and rate of operative complications, as well as presenting a low rate of conversion. Obesity has been shown to be a risk factor for surgical complication in robotic colorectal surgery.

Robotic rectal surgery: Outcomes of the first 102 totally robotic cases handled using the single‐docking technique in a reference institution

“…In 2019, another Brazilian reference center of oncology (the National Cancer Institute, INCA) published data on its experience with 117 cases of robotic colorectal surgery, of which 90 were rectal cancer cases, showing a conversion rate of 1.7%, a median length of hospitalization of 5 days, 13 cases (11%) of anastomosis fistula, reoperation in 16 patients (13.6%), and three cases (2.5%) of postoperative death 22 …”

Robotic surgery in patients with colorectal cancer: Techniques and benefits - Integrative review

“…The results indicated that patients undergoing robotic surgery experienced a significant reduction in blood loss, resulting in less need for transfusions. In addition, there was a reduction in hospital stays and improvements in normal bowel function, indicating a faster recovery of digestive and evacuation functions 11 Other benefits associated with robotic surgery include the minimization of surgical trauma to patients, wider visualization and technological aid for the precise identification of vascular and…”