Laparoscopy Versus Robotic Surgery for Colorectal Cancer

Abstract

Background Minimally invasive approach has gained interest in the treatment of patients with colorectal cancer. The purpose of this study is to analyze the differences between laparoscopy and robotics for colorectal cancer in terms of oncologic and clinical outcomes in an initial experience of a single center. Materials and Methods Clinico-pathological data of 100 patients surgically treated for colorectal cancer from March 2008 to April 2014 with laparoscopy and robotics were analyzed. The procedures were right colonic, left colonic, and rectal resections. A comparison between the laparoscopic and robotic resections was made and an analysis of the first and the last procedures in the 2 groups was performed. Results Forty-two patients underwent robotic resection and 58 underwent laparoscopic resection. The postoperative mortality was 1%. The number of harvested lymph nodes was higher in robotics. The conversion rate was 7.1% for robotics and 3.4% for laparoscopy. The operative time was lower in laparoscopy for all the procedures. No differences were found between the first and the last procedures in the 2 groups. Conclusions This initial experience has shown that robotic surgery for the treatment of colorectal adenocarcinoma is a feasible and safe procedure in terms of oncologic and clinical outcomes, although an appropriate learning curve is necessary. Further investigation is needed to demonstrate real advantages of robotics over laparoscopy.

Outcomes of robotic versus laparoscopic surgery for mid and low rectal cancer after neoadjuvant chemoradiation therapy and the effect of learning curve

“…However, generally, a longer operation time was reported for the robotic procedure. [ 1 – 3 , 7 – 9 , 11 , 13 , 14 , 19 , 26 , 33 , 34 ] In our study, the mean operation time was significantly longer in the Robot 1 group than in the LPS group. However, the mean operation time shortened markedly in the Robot 2 group, approaching that in the LPS group.…”

“…The quality of the surgical specimen and the long-term oncological outcomes of laparoscopic surgery are equivalent to those of open surgery; however, recovery, physiological function, and other short-term outcome measures improve after laparoscopic surgery. [ 1 – 4 ] However, laparoscopic surgery for rectal cancer is technically demanding, limiting its application in nonspecialized centers. The anatomical confinement of the deep pelvis, restricted movement of the rigid instruments, amplification of the tremor from the fulcrum effect, and unstable image provided by the hand-held camera contribute to the difficulty of this procedure.…”

“…A robotic system facilitates precise dissection and maneuvering in a narrow space, such as the pelvis, through a combination of motion scaling and intuitive manipulation. [ 1 , 3 , 7 , 13 ] It may overcome the limitations of laparoscopic surgery for rectal cancer. Studies have demonstrated equivalent outcomes and potential benefits of this robotic approach.…”

Successful patient‐oriented surgical outcomes in robotic vs laparoscopic right hemicolectomy for cancer – a systematic review

“…Completeness of resection and mean distal resection margin were reported in five studies, with three studies reporting complete (R0) resection achieved for all robotic and laparoscopic patients . No study reported significant differences between surgical approaches.…”

Reviewing the Comparison of Robotic Colectomy with the Laparoscopic Ones of All the Procedures based on Determined Parameters

“…[1][2][3][4][5][6][7][8] Laparoscopic surgery (LS) for colon cancer has a wide use due to its beneficial properties and has prevailed compared with open surgery. [9][10][11][12][13][14][15] However, robotic surgery (RS) has been recently introduced as a new contemporary alternative because of its obvious advantages, including the three-dimensional view, the ability to use multidegree-of-freedom forceps, the elimination of physiological tremors, and the stable camera control, in order to broaden the horizons of MIS.…”