Totally Robotic Colorectal Surgery in Singapore: Our Initial Experience Over 3 Years

Kuok-chung Lee, Ker-kan Tan, Seon Hahn Kim, Charles B Tsang, Dean C Koh. National University Health System


Background: Totally robotic colorectal surgery is not widely practiced in view of its technical difficulty and availability of required resources. The aim of this study is to determine the feasibility and short-term outcomes of our initial experience.

Methods: A retrospective review of all patients who underwent robotic colorectal resection from August 2008 to August 2011 was performed. Only totally robotic colorectal technique was adopted in our institution. The standard da Vinci ® Surgical System was used until December 2009 and was replaced by the Si model thereafter.

Results: A total of 47 (31 males, 66.0%) patients with a median age of 62 (range, 21 – 92) years underwent various elective procedures. The majority of the cases (n = 45, 95.7%) were operated for malignant conditions, of which rectal cancer comprised 25 (57.4%) of them. The remaining two benign conditions were for colovesical fistula from diverticulitis and rectal prolapse. Eight (17.0%) patients had a history of previous abdominal surgery.

There were 45 (95.7%) left sided and 2 (4.3%) right sided colonic resections. The median operative and docking times were 315 (range, 163 – 771) minutes and 10 (3 – 34) minutes, respectively. There was one patient who required conversion to conventional laparoscopy surgery for a small bowel serosal tear. The median number of lymph nodes harvested was 16 (range, 4 – 45).

There were 2 patients with anastomotic leakage while another had significant post-operative haemorrhage from a bleeding mesenteric vessel necessitating a laparotomy. Two other patients also had brachial plexus neuropraxia that resolved with conservative management. The median length of stay was 5 (3 – 21) days.

Conclusions: Totally robotic colonic resection using is technically feasible and short-term outcomes are comparable to those of conventional laparoscopic approach.

Session Number: Poster – Poster Presentations
Program Number: P100
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