Effective implementation and adaptation of structured robotic colorectal programme in a busy tertiary unit

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Robotic colorectal surgery adoption is increasing, yet safe implementation with acceptable outcomes in busy tertiary units remains challenging.
• This study details the experience of establishing a structured robotic colorectal program in a high-volume UK center.

Purpose of the Study:

• To evaluate the safety, feasibility, and outcomes of a structured robotic colorectal surgery program.
• To compare short-term and oncological outcomes of robotic colorectal resections (RCcR) with conventional non-robotic colorectal resections (N-RCcR).

Main Methods:

• Two colorectal surgeons completed a comprehensive robotic colorectal training program.
• Data from 30 RCcR were compared with 60 N-RCcR performed prior to the program's implementation.
• Patient demographics, operative details, short-term outcomes, and oncological parameters were analyzed.

Main Results:

• RCcR group showed no conversions, significantly less blood loss (p<0.01), and fewer complications (16.6% vs 25%) compared to N-RCcR.
• Oncological outcomes including TNM staging and resection margins were comparable between groups.
• Length of stay was reduced in the RCcR group (5 vs 7 days), though not statistically significant. No 30-day mortality occurred in either group.

Conclusions:

• A structured training program enables safe and effective implementation of robotic colorectal surgery in high-volume tertiary centers.
• Robotic colorectal surgery offers comparable short-term survival and oncological outcomes during the learning curve.
• The study supports robotic colorectal surgery as a feasible and beneficial approach for cancer resections.