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A Retrospective Observational Study Comparing Short-Term Outcomes in Intracorporeal vs Extracorporeal Robotic Right
Gowtham Sundaram Venkatesan1, Mohammed Arifuzaman1, Vivek Peddakota2
1Colorectal Surgery, James Cook University Hospital, Middlesbrough, GBR.
Cureus
|April 27, 2026
Summary
Robotic right hemicolectomy with intracorporeal anastomosis (ICA) shows lower wound infection and ileus rates compared to extracorporeal anastomosis (ECA) in cancer patients. Oncologic outcomes remain comparable, suggesting ICA offers better short-term recovery.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Robotic right hemicolectomy is a common procedure for neoplastic disease.
- The choice between intracorporeal anastomosis (ICA) and extracorporeal anastomosis (ECA) is debated, with limited evidence in oncologic populations.
- ICA may reduce complications, while ECA is simpler.
Purpose of the Study:
- To compare the outcomes of ICA versus ECA in robotic right hemicolectomy for neoplastic pathology.
- To evaluate early postoperative recovery, wound complications, and oncologic adequacy.
Main Methods:
- Retrospective observational study of 83 patients undergoing robotic right hemicolectomy for cancer (Jan 2023-Dec 2024).
- Patients stratified into ICA (n=61) and ECA (n=22) groups.
- Primary outcomes: bowel movement, anastomotic leak, 30-day readmission. Secondary outcomes: operative time, complications, inflammatory markers, length of stay, oncologic adequacy.
Main Results:
- ICA had longer operative times (176.1 vs 153.7 min) but significantly lower wound infection (0% vs 13.6%) and postoperative ileus (0% vs 13.6%) rates compared to ECA.
- Anastomotic leak rates were low and similar (3.3% vs 0%).
- Readmission rates, inflammatory markers, and length of stay were comparable. Lymph node yield confirmed oncologic adequacy.
Conclusions:
- Intracorporeal anastomosis (ICA) in robotic right hemicolectomy for cancer is associated with reduced wound infections and postoperative ileus compared to extracorporeal anastomosis (ECA).
- ICA does not compromise oncologic adequacy and demonstrates favorable short-term morbidity despite longer operative times.
- Further prospective multicenter studies are recommended to validate these findings and guide surgical practice.
