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Robot-assisted laparoscopic colectomy: 70 cases-one surgeon.

Franziska Huettner1, Arthur L Rawlings1, Wendy B McVay1

  • 1University of Illinois College of Medicine, Peoria, IL, USA.

Journal of Robotic Surgery
|September 18, 2016
PubMed
Summary

Robot-assisted colectomy using the da Vinci system is a safe and feasible surgical option for colon resection. This six-year review of 70 cases shows increasing adoption and favorable outcomes compared to other robotic series.

Keywords:
ColectomyRight colectomyRobotic colectomyRoboticsSigmoid colectomyda Vinci

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Robotics
  • Colorectal Surgery

Background:

  • Robot-assisted surgery is increasingly utilized in various surgical fields.
  • Laparoscopic colectomy offers benefits over open surgery, and robotic assistance may enhance these advantages.
  • Evaluating the early experience with robotic colectomy is crucial for establishing its safety and efficacy.

Purpose of the Study:

  • To review the initial six-year experience with robot-assisted colectomy.
  • To assess the safety, feasibility, and outcomes of robotic colectomy for various colonic pathologies.
  • To analyze operative times, blood loss, length of stay, and complication rates.

Main Methods:

  • A retrospective review of 70 consecutive robot-assisted colectomies performed by a single surgeon between September 2002 and 2007.
  • Data collected included patient demographics, diagnoses (diverticular disease, polyps, cancer, carcinoid), surgical procedure type (right or sigmoid colectomy), operative parameters, and postoperative outcomes.
  • Analysis included port setup time, robotic time, total case time, estimated blood loss (EBL), body mass index (BMI), and length of stay (LOS).

Main Results:

  • A total of 38 right and 32 sigmoid colectomies were performed. The robotic portion constituted 66.5% of total case time for right colectomies and 44.6% for sigmoid colectomies.
  • Mean operative times and EBL were recorded for both procedures. Median LOS was 3 days for right and 4 days for sigmoid colectomies.
  • Eight complications occurred, with five conversions to open surgery and three to laparoscopy; two conversions were due to robot malfunction. Resident participation was noted in 57.1% of cases.

Conclusions:

  • Robot-assisted colectomy is a safe and technically feasible approach for colon resection.
  • The number of robotic colectomies performed annually showed a steady increase over the study period.
  • This series demonstrated comparable or favorable outcomes regarding LOS, conversion rates, and total case time relative to other robotic colectomy studies.