Systematic Review of Robotic-Assisted Colon and Rectal Surgery

Aliyah Kanji, MD, Richdeep S Gill, MD, Xinzhe Shi, MPH, Daniel W Birch, MD, Shahzeer Karmali, MD. Department of Surgery, University of Toronto and University of Alberta


Introduction: Colorectal surgery is one of the most common procedures performed by general surgeons with an increasing number being performed laparoscopically. Robotic technology is emerging as the next evolution in minimally invasive surgery, and may address some of the challenges and limitations of standard laparoscopy. In this study, we systematically review the literature regarding the safety and feasibility of robotic-assisted colorectal surgery.

Methods: An electronic data search of MEDLINE, PubMed, Embase, Scopus, Dare, Clinical Evidence, TRIP, Health Technology Database, Conference abstracts, clinical trials, and the Cochrane Library database was completed. All case series and clinical trials assessing robotic-assisted colorectal surgery were included. The search terms used included robotic, robot, telerobotic, telerobot, computer assisted, computer aided, da Vinci, colorectal, colon, rectal, general surgery, abdominal surgery and gastrointestinal surgery. All human studies, limited to English, from 2000 to August 2010 were included. Two independent reviewers assessed the studies for relevance and inclusion, and extracted data from the full versions of the manuscripts. Data was pooled for statistical analysis.

Results: After an initial screen of 347 titles, 20 studies met the inclusion criteria. A total of 854 patients were included with a mean age of 61 years and a body mass index of 25.5 kg/m2. There were 27 anastomotic leaks from a total of 766 patients (3.5%). There were 10 post-operative bleeds in 854 patients (1.1%). The post-operative infection rate was 1.6% (14/854). There were no mortalities reported. Overall the conversion rate to either conventional laparoscopic or open surgery was 3.7%. Mean operative time was 236 minutes (range 154 to 384) and length of stay was 5.9 days (range 2.6 to 9.8).

Conclusions: This systematic review demonstrates that robotic-assisted colorectal surgery is both a safe and feasible option. However, further research is needed to determine if the increased operational costs are warranted.

Session Number: Poster – Poster Presentations
Program Number: P571
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