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Comparison of robotic right colectomy and laparoscopic right colectomy: a systematic review and meta-analysis

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Abstract

Background

For right colon surgery, there is an increasing body of literature comparing the safety of robotic right colectomy (RRC) with laparoscopic right colectomy (LRC). The aim of the present systematic review and meta-analysis is to assess the safety and efficacy of RRC versus LRC, including homogeneous subgroup analyses for extracorporeal anastomosis (EA) and intracorporeal anastomosis (IA).

Methods

PubMed, Web of Science, Embase, and Cochrane Library databases were searched for studies published between January 2000 and January 2022. Length of hospital stay, operation time, rate of conversion to laparotomy, time to first flatus, number of harvested lymph nodes, estimated blood loss, rate of overall complication, ileus, anastomotic leakage, wound infection, and total costs were measured.

Results

Forty-two studies (RRC: 2772 patients; LRC: 12,469 patients) were evaluated. Regardless of the type of anastomosis, RRC showed shorter length of hospital stay, lower rate of conversion to laparotomy, shorter time to first flatus, lower rate of overall complications, and a higher number of harvested lymph nodes compared with LRC, but longer operative time and higher total costs. In the IA subgroup, RRC had a shorter length of hospital stay, longer operative time, and lower rate of conversion to laparotomy compared with LRC, with no difference for the remaining outcomes. In the EA subgroup, RRC had a longer operative time, lower estimated blood loss, lower rate of overall complications, and higher total costs compared with LRC, with the other outcomes being similar.

Conclusion

The safety and efficacy of RRC is superior to LRC, especially when an intracorporeal anastomosis is performed. Most included articles were retrospective, offering low-quality evidence and limited conclusions.

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References

  1. Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy) [J]. Surg Laparosc Endosc 1(3):144–150

    CAS  PubMed  Google Scholar 

  2. Bonjer HJ, Hop WC, Nelson H et al. (2007) Laparoscopically assisted vs open colectomy for colon cancer: a meta-analysis [J]. Arch Surg 142(3):298–303

    Article  PubMed  Google Scholar 

  3. Fleshman J, Sargent DJ, Green E et al. (2007) Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial [J]. Ann Surg 246(4):655–662

    Article  PubMed  Google Scholar 

  4. Buunen M, Veldkamp R, Hop WC et al. (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial [J]. Lancet Oncol 10(1):44–52

    Article  PubMed  Google Scholar 

  5. Jayne DG, Thorpe HC, Copeland J et al. (2007) Five-year follow up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer [J]. Br J Surg 97(11):1638–1645

    Article  Google Scholar 

  6. Maeso S, Reza M, Mayol JA et al. (2010) Efficacy of the Da Vinci surgical system in abdominal surgery compared with that of laparoscopy: a systematic review and meta-analysis[J]. Ann Surg 252(2):254–262

    Article  PubMed  Google Scholar 

  7. Fransgaard T, Pinar I, Thygesen LC et al. (2018) Association between robot-assisted surgery and resection quality in patients with colorectal cancer [J]. Surg Oncol 27(2):177–184

    Article  PubMed  Google Scholar 

  8. Lim DR, Min BS, Kim MS et al. (2013) Robotic versus laparoscopic anterior resection of sigmoid colon cancer: comparative study of long-term oncologic outcomes [J]. Surg Endosc 27(4):1379–1385

    Article  PubMed  Google Scholar 

  9. Weber PA, Merola S, Wasielewski A et al. (2002) Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease [J]. Dis Colon Rectum 45(12):1689–1694

    Article  PubMed  Google Scholar 

  10. Johnson CS, Kassir A, Marx DS et al. (2019) Performance of da Vinci Stapler during robotic-assisted right colectomy with intracorporeal anastomosis [J]. J Robot Surg 13(1):115–119

    Article  PubMed  Google Scholar 

  11. Helvind NM, Eriksen JR, Mogensen A et al. (2013) No differences in short-term morbidity and mortality after robot-assisted laparoscopic versus laparoscopic resection for colonic cancer: a case-control study of 263 patients [J]. Surg Endosc 27(7):2575–2580

    Article  PubMed  Google Scholar 

  12. Lee HJ, Choi GS, Park JS et al. (2018) A novel robotic right colectomy for colon cancer via the suprapubic approach using the da Vinci Xi system: initial clinical experience [J]. Ann Surg Treat Res 94(2):83–87

    Article  PubMed  PubMed Central  Google Scholar 

  13. Ioannidis A, Kontzoglou K, Kouraklis G et al. (2018) Short-term outcomes in patients with colon cancer treated with robotic right colectomy [J]. J BUON 23(2):317–321

    PubMed  Google Scholar 

  14. Ahmadi N, Mor I, Warner R (2022) Comparison of outcome and costs of robotic and laparoscopic right hemicolectomies [J]. J Robot Surg 16(2):429–436

    Article  PubMed  Google Scholar 

  15. Blumberg D (2019) Robotic colectomy with intracorporeal anastomosis is feasible with no operative conversions during the learning curve for an experienced laparoscopic surgeon developing a robotics program [J]. J Robot Surg 13(4):545–555

    Article  PubMed  Google Scholar 

  16. Cardinali L, Belfiori G, Ghiselli R et al. (2016) Robotic versus laparoscopic right colectomy for cancer: short-term outcomes and influence of body mass index on conversion rate [J]. Minerva Chir 71(4):217–222

    PubMed  Google Scholar 

  17. Casillas MA, Leichtle SW, Wahl WL et al. (2014) Improved perioperative and short-term outcomes of robotic versus conventional laparoscopic colorectal operations [J]. Am J Surg 208(1):33–40

    Article  PubMed  Google Scholar 

  18. Ceccarelli G, Costa G, Ferraro V et al. (2021) Robotic or three-dimensional (3D) laparoscopy for right colectomy with complete mesocolic excision (CME) and intracorporeal anastomosis? A propensity score-matching study comparison [J]. Surg Endosc 35(5):2039–2048

    Article  PubMed  Google Scholar 

  19. Davis BR, Yoo AC, Moore M et al. (2014) Robotic-assisted versus laparoscopic colectomy: cost and clinical outcomes [J]. JSLS 18(2):211–224

    Article  PubMed  PubMed Central  Google Scholar 

  20. deSouza AL, Prasad LM, Park JJ et al. (2010) Robotic assistance in right hemicolectomy: is there a role [J]? Dis Colon Rectum 53(7):1000–1006

    Article  PubMed  Google Scholar 

  21. Deutsch GB, Sathyanarayana SA, Gunabushanam V et al. (2012) Robotic vs. laparoscopic colorectal surgery: an institutional experience [J]. Surg Endosc 26(4):956–963

    Article  PubMed  Google Scholar 

  22. de’Angelis N, Lizzi V, Azoulay D, et al. (2016) Robotic versus laparoscopic right colectomy for colon cancer: analysis of the initial simultaneous learning curve of a surgical fellow [J]. J Laparoendosc Adv Surg Tech A, 26(11):882–892

  23. Dohrn N, Klein MF, Gögenur I (2021) Robotic versus laparoscopic right colectomy for colon cancer: a nationwide cohort study [J]. Int J Colorectal Dis 36(10):2147–2158

    Article  PubMed  Google Scholar 

  24. Dolejs SC, Waters JA, Ceppa EP et al. (2017) Laparoscopic versus robotic colectomy: a national surgical quality improvement project analysis [J]. Surg Endosc 31(6):2387–2396

    Article  PubMed  Google Scholar 

  25. Ferrara F, Piagnerelli R, Scheiterle M et al. (2016) Laparoscopy versus robotic surgery for colorectal cancer: a single-center initial experience [J]. Surg Innov 23(4):374–380

    Article  PubMed  Google Scholar 

  26. Ferri V, Quijano Y, Nuñez J et al. (2021) Robotic-assisted right colectomy versus laparoscopic approach: case-matched study and cost-effectiveness analysis [J]. J Robot Surg 15(1):115–123

    Article  PubMed  Google Scholar 

  27. Gerbaud F, Valverde A, Danoussou D, et al. (2019) Experience with transitioning from laparoscopic to robotic right colectomy [J]. JSLS 23(4): e2019.00044.

  28. Guerrieri M, Campagnacci R, Sperti P et al. (2015) Totally robotic vs 3D laparoscopic colectomy: a single centers preliminary experience [J]. World J Gastroenterol 21(46):13152–13159

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Haskins IN, Ju T, Skancke M et al. (2018) Right colon resection for colon cancer: does surgical approach matter [J]? J Laparoendosc Adv Surg Tech A 28(10):1202–1206

    Article  PubMed  Google Scholar 

  30. Kang J, Park YA, Baik SH et al. (2016) A comparison of open, laparoscopic, and robotic surgery in the treatment of right-sided colon cancer [J]. Surg Laparosc Endosc Percutan Tech 26(6):497–502

    Article  PubMed  Google Scholar 

  31. Kelley SR, Duchalais E, Larson DW (2018) Short-term outcomes with robotic right colectomy [J]. Am Surg 84(11):1768–1773

    Article  PubMed  Google Scholar 

  32. Khan JS, Ahmad A, Odermatt M, et al. (2021) Robotic complete mesocolic excision with central vascular ligation for right colonic tumours—a propensity score-matching study comparing with standard laparoscopy [J]. BJS Open 5(2): zrab016.

  33. Lujan HJ, Maciel VH, Romero R et al. (2013) Laparoscopic versus robotic right colectomy: a single surgeon’s experience [J]. J Robot Surg 7(2):95–102

    Article  PubMed  Google Scholar 

  34. Lujan HJ, Plasencia G, Rivera BX et al. (2018) Advantages of robotic right colectomy with intracorporeal anastomosis [J]. Surg Laparosc Endosc Percutan Tech 28(1):36–41

    Article  PubMed  Google Scholar 

  35. Mégevand JL, Amboldi M, Lillo E, et al. (2019) Right colectomy: consecutive 100 patients treated with laparoscopic and robotic technique for malignancy. Cumulative experience in a single centre [J]. Updat Surg 71(1):151–156.

  36. Merola G, Sciuto A, Pirozzi F et al. (2020) Is robotic right colectomy economically sustainable? A multicentre retrospective comparative study and cost analysis [J]. Surg Endosc 34(9):4041–4047

    Article  PubMed  Google Scholar 

  37. Migliore M, Giuffrida MC, Marano A et al. (2021) Robotic versus laparoscopic right colectomy within a systematic ERAS protocol: a propensity-weighted analysis [J]. Updates Surg 73(3):1057–1064

    Article  PubMed  Google Scholar 

  38. Morpurgo E, Contardo T, Molaro R et al. (2013) Robotic-assisted intracorporeal anastomosis versus extracorporeal anastomosis in laparoscopic right hemicolectomy for cancer: a case control study [J]. J Laparoendosc Adv Surg Tech A 23(5):414–417

    Article  PubMed  Google Scholar 

  39. Ngu JC, Ng YY (2018) Robotics confers an advantage in right hemicolectomy with intracorporeal anastomosis when matched against conventional laparoscopy [J]. J Robot Surg 12(4):647–653

    Article  PubMed  Google Scholar 

  40. Nolan HR, Smith BE, Honaker MD (2018) Operative time and length of stay is similar between robotic assisted and laparoscopic colon and rectal resections [J]. J Robot Surg 12(4):659–664

    Article  PubMed  Google Scholar 

  41. Park JS, Kang H, Park SY et al. (2019) Long-term oncologic after robotic versus laparoscopic right colectomy: a prospective randomized study [J]. Surg Endosc 33(9):2975–2981

    Article  PubMed  Google Scholar 

  42. Rattenborg S, Bundgaard L, Andersen J, et al. (2021) Intracorporeal anastomosis in right hemicolectomy for colon cancer: short‑term outcomes with the DaVinci Xi robot. Journal of Robotic Surgery [J]. J Robot Surg 15(6):915–922.

  43. Rawlings AL, Woodland JH, Vegunta RK et al. (2007) Robotic versus laparoscopic colectomy [J]. Surg Endosc 21(10):1701–1708

    Article  CAS  PubMed  Google Scholar 

  44. Scotton G, Contardo T, Zerbinati A et al. (2018) From laparoscopic right colectomy with extracorporeal anastomosis to robot-assisted intracorporeal anastomosis to totally robotic right colectomy for cancer: the evolution of robotic multiquadrant abdominal surgery [J]. J Laparoendosc Adv Surg Tech A 28(10):1216–1222

    Article  PubMed  Google Scholar 

  45. Shi XL, Zhu XL, Wang H et al. (2020) Robotic versus laparoscopic colectomy for right-sided colon cancer: short-term outcomes from a single center [J]. Chin J Robot Surg 1(5):307–316

    Google Scholar 

  46. Shin JY (2012) Comparison of short-term surgical outcomes between a robotic colectomy and a laparoscopic colectomy during early experience [J]. J Korean Soc Coloproctol 28(1):19–26

    Article  PubMed  PubMed Central  Google Scholar 

  47. Solaini L, Cavaliere D, Pecchini F et al. (2019) Robotic versus laparoscopic right colectomy with intracorporeal anastomosis: a multicenter comparative analysis on short-term outcomes [J]. Surg Endosc 33(6):1898–1902

    Article  PubMed  Google Scholar 

  48. Sorgato N, Mammano E, Contardo T, et al. (2021) Right colectomy with intracorporeal anastomosis for cancer: a prospective comparison between robotics and laparoscopy [J]. J Robot Surg. https://doi.org/10.1007/s11701-021-01290-9.

  49. Spinoglio G, Bianchi PP, Marano A et al. (2018) Robotic versus laparoscopic right colectomy with complete mesocolic excision for the treatment of colon cancer: perioperative outcomes and 5-year survival in a consecutive series of 202 patients [J]. Ann Surg Oncol 25(12):3580–3586

    Article  PubMed  Google Scholar 

  50. Tagliabue F, Burati M, Chiarelli M et al. (2020) Robotic vs laparoscopic right colectomy—the burden of age and comorbidity in perioperative outcomes: an observational study [J]. World J Gastrointest Surg 12(6):287–297

    Article  PubMed  PubMed Central  Google Scholar 

  51. Trastulli S, Coratti A, Guarino S et al. (2015) Robotic right colectomy with intracorporeal anastomosis compared with laparoscopic right colectomy with extracorporeal and intracorporeal anastomosis: a retrospective multicentre study [J]. Surg Endosc 29(6):1512–1521

    Article  PubMed  Google Scholar 

  52. Widmar M, Keskin M, Beltran P et al. (2016) Incisional hernias after laparoscopic and robotic right colectomy [J]. Hernia 20(5):723–728

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. WidmarM, Keskin M, Strombom P, et al. (2017) Lymph node yield in right colectomy for cancer: a comparison of open, laparoscopic and robotic approaches [J]. Colorectal Dis 19(10):888–894.

  54. Yozgatli TK, Aytac E, Ozben V et al. (2019) Robotic complete mesocolic excision versus conventional laparoscopic hemicolectomy for right-sided colon cancer [J]. J Laparoendosc Adv Surg Tech A 29(5):671–676

    Article  PubMed  Google Scholar 

  55. Zeng YJ, Wang GH, Liu Y et al. (2020) The ‘“Micro Hand S”’ robot-assisted versus conventional laparoscopic right colectomy: short-term outcomes at a single center [J]. J Laparoendosc Adv Surg Tech A 30(4):363–368

    Article  PubMed  Google Scholar 

  56. Araujo SE, Seid VE, Klajner S (2014) Robotic surgery for rectal cancer: current immediate clinical and oncological outcomes [J]. World J Gastroenterol 20(39):14359–14370

    Article  PubMed  PubMed Central  Google Scholar 

  57. Mak TW, Lee JF, Futaba K et al. (2014) Robotic surgery for rectal cancer: a systematic review of current practice [J]. World J Gastrointest Oncol 6(6):184–193

    Article  PubMed  PubMed Central  Google Scholar 

  58. Woeste G, Bechstein WO, Wullstein C (2005) Does telerobotic assistance improve laparoscopic colorectal surgery [J]? Int J Colorectal Dis 20(3):253–257

    Article  PubMed  Google Scholar 

  59. Balch GC (2009) Emerging role of laparoscopic and robotic surgery for rectal cancers [J]. Ann Surg Oncol 16(6):1451–1453

    Article  PubMed  Google Scholar 

  60. Ahmed K, Khan MS, Vats A et al. (2009) Current status of robotic assisted pelvic surgery and future developments [J]. Int J Surg 7(5):431–440

    Article  PubMed  Google Scholar 

  61. Trinh BB, Jackson NR, Hauch AT, et al. (2014) Robotic versus laparoscopic colorectal surgery [J]. JSLS 18(4).

  62. Zarak A, Castillo A, Kichler K et al. (2015) Robotic versus laparoscopic surgery for colonic disease: a meta-analysis of postoperative variables [J]. Surg Endosc 29(6):1341–1347

    Article  PubMed  Google Scholar 

  63. Papanikolaou IG (2014) Robotic surgery for colorectal cancer: systematic review of the literature [J]. Surg Laparosc Endosc Percutan Tech 24(6):478–483

    Article  PubMed  Google Scholar 

  64. Petrucciani N, Sirimarco D, Nigri G et al. (2015) Robotic right colectomy: a worthwhile procedure? Results of a meta-analysis of trials comparing robotic versus laparoscopic right colectomy [J]. J Minim Access Surg 11(1):22–28

    Article  PubMed  PubMed Central  Google Scholar 

  65. Tandogdu Z, Vale L, Fraser C et al. (2015) A systematic review of economic evaluations of the use of robotic assisted laparoscopy in surgery compared with open or laparoscopic surgery [J]. Appl Health Econ Health Policy 13(5):457–467

    Article  PubMed  Google Scholar 

  66. Waters PS, Cheung FP, Peacock O et al. (2020) Successful patient-oriented surgical outcomes in robotic vs laparoscopic right hemicolectomy for cancer-a systematic review [J]. Colorectal Dis 22(5):488–499

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Emergency, The Second Hospital of Jiaxing: The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China

    Jianchun Zheng, Wei Chen, Ming Zhang & Jianxiang Wu

  2. Department of General Surgery, Northern Jiangsu People‘s Hospital Affiliated to Medical School of Nanjing University, Yangzhou, Jiangsu Province, China

    Shuai Zhao

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  1. Jianchun Zheng
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Correspondence to Jianxiang Wu.

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Zheng, J., Zhao, S., Chen, W. et al. Comparison of robotic right colectomy and laparoscopic right colectomy: a systematic review and meta-analysis. Tech Coloproctol 27, 521–535 (2023). https://doi.org/10.1007/s10151-023-02821-2

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