腹腔鏡手術からロボット支援手術への切り替えの分析：憩室疾患を対象とした比較コホート研究

The aim of this study was to compare short term clinical outcomes for patients having robotic or laparoscopic diverticular resection in the elective setting. This was a single center cohort study of consecutive patients having elective minimally invasive left-sided diverticular resection between February 2018 and March 2025 for symptomatic inflammation, stricture, abscess or fistula. All robotic procedures were carried out using the DaVinci Xi system (Intuitive Surgical). The primary outcome was rate of open conversion. Secondary outcomes included operative time, blood loss, stoma formation, duration of patient-controlled analgesia, time to gut function, length of stay and complications. Seventy-two patients were included, 40 in the robotic group and 32 in the laparoscopic group. Open conversion rate, blood loss and patient-controlled analgesia use were significantly reduced in patients having robotic compared to laparoscopic surgery, at the cost of operative time. Robotic surgery was an independent predictor of lower conversion rate, lower blood loss and higher operative time in regression models. Robotic surgery for elective diverticular resection may enable a greater proportion of patients to benefit from minimally invasive approach without the need for open conversion.