Totally robotic vs 3D laparoscopic colectomy: A single centers preliminary experience.

Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Rosaria Gesuita, Roberto Ghiselli
Author Information
  1. Mario Guerrieri: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
  2. Roberto Campagnacci: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
  3. Pierluigi Sperti: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
  4. Giulio Belfiori: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
  5. Rosaria Gesuita: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
  6. Roberto Ghiselli: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.

Abstract

AIM: To compare robotic and three-dimensional (3D) laparoscopic colectomy based on the literature and our preliminary experience.
METHODS: This retrospective observational study compared operative measures and postoperative outcomes between laparoscopic 3D and robotic colectomy for cancer. From September 2013 to September 2014, 24 robotic colectomies and 23 3D laparoscopic colectomy were performed at our Department. Data were analyzed and reported both by approach and by colectomy side. Robotic left colectomy (RL) vs laparoscopic 3D left colectomy (LL 3D) and Robotic right colectomy (RR) vs laparoscopic 3D (LR 3D). Rectal cancer procedures were not included.
RESULTS: There were 18 RR and 11 LR 3D, 6 RL and 12 LL 3D. As regards LR 3D, extracorporeal anastomosis (EA) was performed in 7 patients and intracorporeal anastomosis (IA) in 4; the RR group included 14 IA and 4 EA. There was no mortality. Median operative time was higher for the robotic group while conversion rate (12.5% vs 13%) and lymph nodes removed (14 vs 13) were similar for both. First flatus time was 1 d for RR and 2 d the other patient groups. Oral intake was resumed in 1 d by LR and in 2 d by the other patients (P = 0.012). Overall cost was €4950 and €1950 for RL and LL 3D, and €4450 and €1450 for RR and LR 3D, respectively.
CONCLUSION: There were no differences between RR and LR 3D, except that IA was easier with RR, and probably contributed with the learning curve to the longer operative time recorded. Both techniques offer similar advantages for the patient with significantly different costs. In left colectomies robotic colectomy provided better outcomes, especially in resections approaching the rectum.

Keywords

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MeSH Term

Aged
Clinical Competence
Colectomy
Colonic Neoplasms
Cost-Benefit Analysis
Female
Hospital Costs
Humans
Laparoscopy
Learning Curve
Lymph Node Excision
Lymphatic Metastasis
Male
Middle Aged
Operative Time
Postoperative Complications
Recovery of Function
Retrospective Studies
Robotic Surgical Procedures
Time Factors
Treatment Outcome

Word Cloud

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