Robotic right colectomy with robotic-sewn anastomosis: a pilot case series

The background of this study is to assess the feasibility, clinical utility and safety of intra-corporeal robotic-sewn anastomosis (ICrA) in completely robotic right hemicolectomy (CRH) for adenocarcinoma. A protocol for completely robotic right hemicolectomy (CRH) and intra-corporeal robotic-sewn anastomosis (ICrA), was established at the authors' institution from January 2012 through December 2017. Univariate and multivariable models were constructed to explore the prognostic significance of clinical and surgical findings. Survival and recurrence analysis were performed using standard univariable and multivariable methods. The study population consisted of 123 patients. The median number of examined lymph nodes (ELN) was 25 (range 1-59), the median number of positive lymph nodes (PLN) was 1 (range 0-21). Mean operative time was 240 min (SD 43.56, range 180-360 min), and conversion to open rate was 0%. Anastomotic leaks rate was 1.6%. The median overall survival was 69 months. This pilot series, in which an intra-corporeal robotic-sewn anastomosis (ICrA) was performed during CRH, demonstrated the safety and feasibility of this approach. Compared to the current standard of care at a high-volume center, ICrA was associated with post-operative surgical outcomes similar to those reported in the literature. These results call for further validation in a prospective and controlled setting to be fully incorporated into clinical practice.