Robotic colorectal procedures: does operative start time impact short-term outcome?

Area of Science:

• Surgical Outcomes
• Robotic Surgery
• Colorectal Surgery

Background:

• Previous studies indicated higher complication rates in afternoon surgeries.
• The impact of surgery start time on robotic surgery outcomes requires investigation.

Purpose of the Study:

• To evaluate if morning versus afternoon start times affect robotic colorectal surgery outcomes.
• To compare preoperative risk factors, intraoperative events, and 30-day postoperative outcomes between morning and afternoon robotic colorectal surgeries.

Main Methods:

• Retrospective review of a prospective database including 210 robotic colorectal surgeries.
• Comparison of 97 morning cases versus 113 afternoon cases.
• Statistical analysis using independent samples t-test, Fisher's exact test, and linear regression.

Main Results:

• Morning patients were younger but had similar BMI, comorbidity scores, operative time, and blood loss compared to afternoon patients.
• Morning surgeries resulted in a shorter length of stay (6.0 vs. 8.0 days).
• No significant differences were observed in overall postoperative complications, wound infections, anastomotic leaks, ileus, or 30-day readmissions between morning and afternoon procedures.

Conclusions:

• No correlation was found between robotic colorectal surgery start time and intra- or postoperative outcomes.
• Experienced surgical teams, high-volume centers, and superior robotic surgery ergonomics may explain the lack of difference.
• These factors may mitigate previously reported negative impacts of afternoon surgery start times.