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Perioperative outcomes of laparoscopic low anterior resection using ArtiSential® versus robotic approach in patients with rectal cancer: a propensity score matching analysis

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Abstract

Background

Total mesorectal excision using conventional straight fixed devices may be technically difficult because of the narrow and concave pelvis. Several laparoscopic articulating tools have been introduced as an alternative to robotic systems. The aim of this study was to compare perioperative outcomes between laparoscopic low anterior resection using ArtiSential® and robot-assisted surgery for rectal cancer.

Methods

This retrospective study included 682 patients who underwent laparoscopic or robotic low anterior resection  for rectal cancer from September 2018 to December 2021. Among them, 82 underwent laparoscopic surgery using ArtiSential® (group A) and 201 underwent robotic surgery (group B). A total of 73 [group A; 66.37 ± 11.62; group B 65.79 ± 11.34] patients were selected for each group using a propensity score matching analysis.

Results

There was no significant difference in the baseline characteristics between group A and B. Mean operative time was longer in group B than A (163.5 ± 61.9 vs 250.1 ± 77.6 min, p < 0.001). Mean length of hospital stay was not significantly different between the two groups (6.2 ± 4.7 vs 6.7 ± 6.1 days, p = 0.617). Postoperative complications, reoperation, and readmission within 30 days after surgery were similar between the two groups.

Pathological findings revealed that the circumferential resection margins were above 10 mm in both groups (11.00 ± 7.47 vs 10.17 ± 6.25 mm, p = 0.960). At least 12 lymph nodes were sufficiently harvested, with no significant difference in the number harvested between the groups (20.5 ± 9.9 vs 19.7 ± 7.3, p = 0.753).

Conclusions

Laparoscopic low anterior resection using ArtiSential® can achieve acceptable clinical and oncologic outcomes. ArtiSential®, a multi-joint and articulating device, may serve a feasible alternative approach to robotic surgery in rectal cancer.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was funded by Innovative medical device clinical trial support project of SeongNam Industry Promotion Agency, SeongNam, Korea (5-2022-D0781-00001).

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Author notes

  1. I. K. Kim and C. S. Lee contributed equally to this work.

Authors and Affiliations

  1. Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary’s Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    I. K. Kim, J. H. Bae, S. R. Han, W. Alshalawi, B. C. Kim, I. K. Lee, D. S. Lee & Y. S. Lee

  2. Department of Colorectal Surgery, Hansol Hospital, Seoul, Republic of Korea

    C. S. Lee

  3. Department of Surgery, King Saud Medical City, Riyadh, Saudi Arabia

    W. Alshalawi

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  1. I. K. Kim
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Contributions

Conceptulization: YSL; Data curation: IKK, CSL; Formal analysis: CSL; Investigation: IKK, CSL, YSL; Methodology: IKK, CSL, JHB, SRH, WA, BCK, IKL, DSL, YSL; Project administration: IKK, CSL, YSL; Resources: IKK, CSL, JHB, SRH, WA, BCK, IKL, DSL, YSL; Software: IKK, CSL; Supervision: IKL, DSL, YSL; Validation: JHB, SRH, WA, BCK, IKL, DSL, YSL; Visualization: IKK, CSL; Writing original draft: IKK, CSL; Writing review and editing: YSL.

Corresponding author

Correspondence to Y. S. Lee.

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Conflict of interest

In Kyeong Kim, Chul Seung Lee, Jung Hoon Bae, Seung Rim Han, Wed Alshalawi, Byung Chul Kim, In Kyu Lee, Do Sang Lee, and Yoon Suk Lee have no conflicts of interest or financial ties to disclose.

Ethical approval

This study was approved by the Institutional Review Board of Seoul St. Mary’s Hospital, Catholic University of Korea (No. KC22RASI0161).

Informed consent

All patients were informed, and they agreed with the process.

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Kim, I.K., Lee, C.S., Bae, J.H. et al. Perioperative outcomes of laparoscopic low anterior resection using ArtiSential® versus robotic approach in patients with rectal cancer: a propensity score matching analysis. Tech Coloproctol 28, 25 (2024). https://doi.org/10.1007/s10151-023-02895-y

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