Robot-assisted laparoscopic colectomy: 70 cases-one surgeon

This study reviewed the use of robot-assisted laparoscopic surgery for colon resection. We described the six-year experience of one minimally invasive fellowship-trained surgeon performing 70 consecutive colectomies using the da Vinci system. Between September 2002 and 2007, data on 70 patients undergoing robotic colectomy for diverticular disease, polyps, cancer, or carcinoid tumor were collected. Operations were right colectomy and sigmoid colectomy. A total of 38 right and 32 sigmoid colectomies were performed in 32 males and 38 females. The postoperative diagnoses were diverticular disease (19), polyps (36), cancer (13), and carcinoid (2). Times for the right colectomies were: port setup time 33.6 ± 12.1 (20-64) min, robotic time 147.2 ± 44.4 (53-306) min, and total case time 221.3 ± 43.7 (150-380) min. The estimated blood loss (EBL) was 53.9 ± 78.2 (15-500) ml, the body mass index (BMI) 27.2 ± 4.2 (17-36.8) kg/m(2), and the median length of stay (LOS) 3 (2-27) days. The robotic portion represented 66.5 % of the total case time. Times for the sigmoid colectomies were: port setup time 30.0 ± 9.8 (10-57) min, robotic time 101.8 ± 25.3 (67-165) min, and total case time 228.4 ± 40.5 (147-323) min. The EBL was 71.2 ± 47.9 (15-200) ml, the BMI 27.1 ± 4.9 (17.0-40.5) kg/m(2), and the median LOS 4 (2-27) days. The robotic portion represented 44.6% of the total case time. Eight different types of complication occurred. Eight cases were converted-five to open and three to laparoscopic. Two resulted from robot malfunction. Residents participated in 40 cases (57.1%). In the years 2002-2006, respectively, 5, 12, 10, 11, and 19 robotic colectomies were performed. In the first nine months of 2007, 13 robotic colectomies were performed. These 70 consecutive cases have demonstrated robotic colectomy to be a safe and technically feasible approach. The number of robotic colectomies performed each year has steadily increased over the last six years. This series compared favorably with other robotic series in length of hospital stay, conversion rates, and total case time.