Robotic Right Colon Resection: Evaluation of First 50 Consecutive Cases for Malignant Disease

D’Annibale, Annibale; Pernazza, Graziano; Morpurgo, Emilio; Mikaelian, Igor; Pende, Vito; Lucandri, Giorgio; Termini, Barbara; Orsini, Camillo; Sovernigo, Gianna

doi:10.1245/s10434-010-1175-0

Cited by 114 publications

(57 citation statements)

References 34 publications

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“…Previous studies [17-20] have reported mean console times for robotic proctectomies [18, 19], sigmoid colectomies [20] and right colectomies of 180, 100, and 180 minutes, respectively [17, 20]. Although the console time found in the current study was somewhat longer than those reported in previous publications [17-20], only small numbers of patients were included in those previous articles.…”

Section: Discussioncontrasting

confidence: 50%

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Comparison of Short-term Surgical Outcomes between a Robotic Colectomy and a Laparoscopic Colectomy during Early Experience

Shin

2012

J Korean Soc Coloproctol

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PurposeAlthough robotic surgery was invented to overcome the technical limitations of laparoscopic surgery, the role of a robotic (procto)colectomy (RC) for the treatment of colorectal cancer compared to that of a laparoscopic (procto)colectomy (LC) was not well defined during the initial adoption periods of both procedures. This study aimed to evaluate the efficacy and the safety of a RC for the treatment of colorectal cancer by comparing the authors' initial experiences with both a RC and a LC.MethodsThe first 30 patients treated by using a RC for colorectal cancer from July 2010 to March 2011 were compared with the first 30 patients treated by using a LC for colorectal cancer from December 2006 to June 2007 by the same surgeon. Perioperative variables and short-term outcomes were analyzed. In addition, the 30 RC and the 30 LC cases involved were divided into rectal cancer (n = 17 and n = 12, respectively), left-sided colon cancer (n = 7 and n = 12, respectively) and right-sided colon cancer (n = 6 and n = 6, respectively) for subgroup analyses.ResultsThe mean operating times for RC and LC were significantly different at 371.8 and 275.5 minutes, respectively, but other perioperative parameters (rates of open conversion, numbers of retrieved lymph node, estimated blood losses, times to first flatus, maximal pain scores before discharge and postoperative hospital stays) were not significantly different in the two groups. Subgroup analyses showed that the mean operative times for a robotic proctectomy and a laparoscopic proctectomy were 396.5 and 298.8 minutes, respectively (P < 0.000). Postoperative complications occurred in five patients in the RC group and in six patients in the LC group (P = 0.739).ConclusionAlthough the short-term outcomes of a RC during its initial use were better than those of a LC (with the exception of operating time), differences were not found to be significantly different. On the other hand, the longer operation time of a robotic proctectomy compared to that of a laparoscopic proctectomy during the early period may be problematic.

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Section: Discussioncontrasting

confidence: 50%

“…The reason for the longer operative time for the robotic proctectomy group appears to be related to less experience of the surgeon and the surgical team. As Spinoglio et al [9] and D'Annibale et al [17] suggested in their reports, operation times will be reduced with increasing surgeon experience.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Short-term Surgical Outcomes between a Robotic Colectomy and a Laparoscopic Colectomy during Early Experience

Shin

2012

J Korean Soc Coloproctol

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“…Many factors influence operative times, and these include set-up time, docking time, learning curve, and the type of anastomosis [26]. In terms of right colectomy, either a hybrid technique or repositioning of the robotic cart is required [27].…”

Section: Discussionmentioning

confidence: 99%

Robotic versus laparoscopic right colectomy: a meta-analysis

Sun

et al. 2014

World J Surg Onc

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BackgroundThe objective of this meta-analysis was to compare the clinical safety and efficacy of robotic right colectomy (RRC) with conventional laparoscopic right colectomy (LRC).MethodsA literature search was performed for comparative studies reporting perioperative outcomes of RRC and LRC. The methodological quality of the selected studies was assessed. Depending on statistical heterogeneity, the fixed effects model or the random effects model were used for the meta-analysis. Operative time, estimated blood loss, length of hospital stay, conversion rates to open surgery, postoperative complications, and related outcomes were evaluated.ResultsSeven studies, including 234 RRC cases and 415 conventional LRC cases, were analyzed. The meta-analysis showed that RRC had longer operative times (P < 0.00001), lower estimated blood losses (P = 0.0002), lower postoperative overall complications (P = 0.02), and significantly faster bowel function recovery (P < 0.00001). There were no differences in the length of hospital stay (P = 0.12), conversion rates to open surgery (P = 0.48), postoperative ileus (P = 0.08), anastomosis leakage (P = 0.28), and bleeding (P = 0.95).ConclusionsCompared to LRC, RRC was associated with reduced estimated blood losses, reduced postoperative complications, longer operative times, and a significantly faster recovery of bowel function. Other perioperative outcomes were equivalent.

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“…They consistently demonstrated the safety and feasibility of RC. 16–19,22 So far, 3 retrospective comparative studies 20,22,35 and 1 randomized clinical trial 36 have been published. None of them found significant differences in LOS or complication rate between RC and LC.…”

Section: Discussionmentioning

confidence: 99%

“…12–14 To our knowledge, only limited published data exist on robot-assisted colectomies (RCs). They mainly consist of single-institution early outcome reports 15–19 and retrospective comparative studies on RCs. 20–22 These early results have demonstrated that RC, while being equivalent in safety and feasibility, usually incurs a higher cost, even beyond the initial purchase of the robot.…”

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Is Minimally Invasive Colon Resection Better Than Traditional Approaches?

et al. 2014

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IMPORTANCE Minimally invasive colectomies are increasingly popular options for colon resection. OBJECTIVE To compare the perioperative outcomes and costs of robot-assisted colectomy (RC), laparoscopic colectomy (LC), and open colectomy (OC). DESIGN, SETTING, AND PARTICIPANTS The US Nationwide Inpatient Sample database was used to examine outcomes and costs before and after propensity score matching across the 3 surgical approaches. This study involved a sample of US hospital discharges from 2008 to 2010 and all patients 21 years of age or older who underwent elective colectomy. MAIN OUTCOMES AND MEASURES In-hospital mortality, complications, ostomy rates, conversion to open procedure, length of stay, discharge disposition, and cost. RESULTS Of the 244 129 colectomies performed during the study period, 126 284 (51.7%) were OCs, 116 261 (47.6%) were LCs, and 1584 (0.6%) were RCs. In comparison with OC, LC was associated with a lower mortality rate (0.4%vs 2.0%), lower complication rate (19.8%vs 33.2%), lower ostomy rate (3.5 vs 13.0%), shorter median length of stay (4 vs 6 days), a higher routine discharge rate (86.1%vs 68.4%), and lower overall cost than OC ($11 742 vs $13 666) (all P < .05). Comparison between RC and LC showed no significant differences with respect to in-hospital mortality (0.0%vs 0.7%), complication rates (14.7%vs 18.5%), ostomy rates (3.0% vs 5.1%), conversions to open procedure (5.7%vs 9.9%), and routine discharge rates (88.7%vs 88.5%) (all P > .05). However, RC incurred a higher overall hospitalization cost than LC ($14 847 vs $11 966, P < .001). CONCLUSIONS AND RELEVANCE In this nationwide comparison of minimally invasive approaches for colon resection, LC demonstrated favorable clinical outcomes and lower cost than OC. Robot-assisted colectomy was equivalent in most clinical outcomes to LC but incurred a higher cost.

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Robotic Right Colon Resection: Evaluation of First 50 Consecutive Cases for Malignant Disease

Cited by 114 publications

References 34 publications

Comparison of Short-term Surgical Outcomes between a Robotic Colectomy and a Laparoscopic Colectomy during Early Experience

Comparison of Short-term Surgical Outcomes between a Robotic Colectomy and a Laparoscopic Colectomy during Early Experience

Robotic versus laparoscopic right colectomy: a meta-analysis

Is Minimally Invasive Colon Resection Better Than Traditional Approaches?

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