Abstract
Background
Evidence regarding the outcomes benefits of robotic approach, when compared to a laparoscopic approach, in colectomy remain limited.
Objective
This study aimed to analyze the value of robotic approach compared to laparoscopic approach in minimally invasive colectomy.
Design
Cohort study of the National Surgical Quality Improvement Program (NSQIP).
Setting
This study included data from the NSQIP from 1/2016 to 12/2021.
Patient
Adult patients undergoing minimally invasive (laparoscopic or robotic) colorectal surgery.
Intervention
Robotic versus laparoscopic colectomy.
Outcome measures
Risk ratios for the incidence of medical and surgical morbidity and overall mortality.
Results
Compared to laparoscopic, robotic colectomy was associated with a significant decrease in postoperative morbidity [RR 0.84 (95%CI 0.72–0.96), P < 0.001], a significant reduction in postoperative mortality [RR 0.83 (95%CI 0.79–0.90), P 0.010)], and in post operative ileus [RR: 0.80 (95%CI 0.75–0.84), P < 0.001]. Yet, robotic approach was associated with a significant increase in total operative time despite a significant decrease in total length of stay. No benefit was observed regarding anastomotic leak.
Limitations
Observational nature of the study cannot exclude residual bias.
Conclusions
In this prospective cohort from the NSQIP, robotic colectomy was associated with a significant reduction in postoperative ileus, unplanned conversion to open surgery, morbidity, and overall mortality when compared to laparoscopic colectomy.
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Ms. Hannah Bossie works for Intuitive inc as a Medical Science Liaison and is a stockholder of the company. Ms Bossie did not participate in the statistical analysis or in the results/ conclusions sections of the manuscript. Dr Rodrigo Leite, Dr. Rocco Ricciardi, Dr. Sergio Eduardo Alonso Araujo, Mr. Gustavo Yano Callado, Dr. Alexandre Venancio de Souza, Dr. Robert Neil Goldstone, Dr. Todd Francone, Dr Leandro Barchi, Dr. Larissa Fagundes, Dr. Ulysses Ribeiro jr does not have any conflicts of interest to declare.
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de Almeida Leite, R.M., Araujo, S.E.A., de Souza, A.V. et al. Surgical and medical outcomes in robotic compared to laparoscopic colectomy global prospective cohort from the American college of surgeons national surgical quality improvement program. Surg Endosc 38, 2571–2576 (2024). https://doi.org/10.1007/s00464-024-10717-x
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DOI: https://doi.org/10.1007/s00464-024-10717-x