Robotic Versus Laparoscopic Colorectal Resection: Are We There Yet?

Area of Science:

• Colorectal Surgery
• Surgical Technology
• Minimally Invasive Surgery

Background:

• Laparoscopy-assisted surgery (LAS) for colorectal cancer (CRC) emerged in 1991, followed by robotic-assisted surgery (RAS) in 2002.
• Robotic-assisted colorectal surgery (RACS) is gaining traction, yet comparative outcome data are limited.
• This study aimed to compare mortality outcomes between laparoscopic and robotic elective colon resections.

Purpose of the Study:

• To compare the outcomes of robotic-assisted colorectal surgery (RACS) versus laparoscopic-assisted colorectal resection (LACR).
• To evaluate differences in readmission rates, length of hospital stay, and other post-operative complications.
• To provide data for community hospitals considering these surgical techniques.

Main Methods:

• A retrospective review of 2089 patients undergoing elective colectomies between 2014 and 2018.
• Comparison of outcomes between 306 patients who underwent RACS and 1783 patients who underwent LACR.
• Analysis focused on specific post-operative outcomes and complications.

Main Results:

• The 30-day readmission rate was significantly lower for LACR (445.4%) compared to RACS (53.9%, p=0.006).
• The length of hospital stay was significantly shorter for RACS (median 3 days) versus LACR (median 4 days, p=0.0001).
• No significant differences were observed in incisional hernias, anastomotic leaks, pain control, surgical site infections, or conversion rates.

Conclusions:

• Both LACR and RACS demonstrated similar outcomes regarding incisional hernias, anastomotic leaks, pain control, surgical site infections, and conversion rates.
• LACR was associated with a significantly lower 30-day readmission rate compared to RACS.
• RACS offered a significantly shorter hospital stay, suggesting potential benefits in specific patient populations or settings.