Propensity score-matched comparison of robotic and laparoscopic right hemicolectomies with intracorporeal anastomosis

Comparisons between robotic and laparoscopic right hemicolectomy have largely been based on older robotic systems, early case series or unmatched retrospective studies. This study aimed to provide propensity score-matched data from surgeons proficient in both minimally invasive approaches.

Audit data from patients who underwent elective robotic right-sided hemicolectomies between November 2015 and November 2025 were reviewed. The operative technique was standardised to include only cases with intracorporeal anastomosis, with other patient and operative variables matched to a laparoscopic group. Perioperative management was in accordance with an enhanced recovery after surgery protocol. Outcomes and histopathological data were compared.

Ninety patients were available for analysis after matching. The median operative time was comparable between the robotic-assisted surgery and laparoscopy groups (210 vs. 215 min, P = 0.997). The use of robotic assistance was associated with a reduction in postoperative complication rates (20.0% vs. 40.0%, P = 0.038) and a significantly earlier discharge from hospital (4 vs. 6 days, P = 0.003). There was no significant difference in short-term oncological outcomes.

While many outcomes were comparable with conventional laparoscopic right hemicolectomy, robotic assistance appeared to provide certain benefits that could be clinically significant for both patients and the healthcare system. Further studies are required to evaluate the cost-effectiveness of these benefits.