Reza Gamagami, MD, Venkata R Kakarla, MD, Katherine V Powers, PAC. Silver Cross Hospital
Introduction: Robotic technology in colorectal surgery has facilitated the performance of more complex and technically demanding resections. Prior to robotics, our institution was highly selective in identifying patients as candidates for laparoscopic procedures to reduce the conversion rate.
The aim of the study was to analyze and compare the short-term clinical outcomes between the selected laparoscopic and unselected robotic resections for patients undergoing sigmoid colectomies at a single institution.
Methods and Procedures: We conducted a retrospective chart review from 23 patients who underwent laparoscopic resections and 50 patients who underwent robotic-assisted sigmoid colectomies in a three-year period. Data analyzed included patient demographics, operative times, blood loss, time to return of bowel function, length of stay, intraoperative or postoperative complications, conversion rates, 30-day readmission and mortality.
Results: There was no statistical difference in age, BMI and ASA between the two groups. The mean length of stay (2.5 vs. 3 days) and postoperative complications (5.5% vs. 6.9%) were comparable between robotic and laparoscopic groups.
The operative time was longer in robotic surgery (236 vs.191 minutes, p=0.0003). Fifty percent of patients in the robotic group had complicated diverticular disease as compared to 21% in the laparoscopic group. The mean blood loss (51 vs. 91 ml, p=0.0064) was significantly statistically less in the robotic group. There were no conversions or anastomotic leakage in either group. Readmission was 2.7% in robotic vs. 4.1% in the laparoscopic group, which is not statistically significant.
Conclusion: Unselected patients undergoing robotic-assisted sigmoid colectomy can expect similar short-term clinical outcomes to patients selected for laparoscopic approach. Complicated diverticular disease was more prevalent in the robotic cohort with significantly greater operative times and less blood loss.
Robotic sigmoid colectomy provides favorable outcomes in unselected patients requiring resection.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80612
Program Number: P228
Presentation Session: Poster (Non CME)
Presentation Type: Poster
