Laparoscopic Versus Robotic Proctectomy Outcomes: An ACS-NSQIP Analysis

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Colorectal Surgery

Background:

• Robotic platforms are increasingly utilized in colorectal surgery.
• Updated evaluations of minimally invasive proctectomy are needed due to platform upgrades and new reporting standards.
• The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) provides valuable data for such evaluations.

Purpose of the Study:

• To compare outcomes between robotic and laparoscopic proctectomy.
• To evaluate the impact of robotic surgery on minimally invasive proctectomy.
• To utilize ACS-NSQIP data for a comprehensive outcome analysis.

Main Methods:

• Analysis of the ACS-NSQIP data set for adult patients undergoing elective proctectomy in 2016-2017.
• Collection of demographics, preoperative, intraoperative, and postoperative data.
• Application of propensity-weighted analysis to compare robotic versus laparoscopic approaches.

Main Results:

• A robotic approach was associated with decreased conversion to open operation (-6.7%).
• Robotic proctectomy resulted in a shorter length of stay (-0.6 days) and reduced postoperative ileus (-3.7%).
• The robotic approach led to an increased operative time (+20.3 minutes).

Conclusions:

• Robotic proctectomy offers advantages over laparoscopy, including reduced conversion rates, shorter hospital stays, and less postoperative ileus.
• While robotic surgery demonstrates clinical benefits, further research is required to assess its cost-effectiveness.
• The findings support the growing role of robotic surgery in colorectal procedures.