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Surgical Endoscopy

, Volume 28, Issue 1, pp 212–221 | Cite as

Comparative effectiveness of laparoscopic versus robot-assisted colorectal resection

  • Deborah S. KellerEmail author
  • Anthony J. Senagore
  • Justin K. Lawrence
  • Brad J. Champagne
  • Conor P. Delaney
Article

Abstract

Background

During the past 20 years, laparoscopy has revolutionized colorectal surgery. With proven benefits in patient outcomes and healthcare utilization, laparoscopic colorectal surgery has steadily increased in use. Robotic surgery, a new addition to colorectal surgery, has been suggested to facilitate and overcome limitations of laparoscopic surgery. Our objective was to compare the outcomes of robot-assisted laparoscopic resection (RALR) to laparoscopic resections (LAP) in colorectal surgery.

Methods

A national inpatient database was evaluated for colorectal resections performed over a 30-month period. Cases were divided into traditional LAP and RALR resection groups. Cost of robot acquisition and servicing were not measured. Main outcome measures were hospital length of stay (LOS), operative time, complications, and costs between groups.

Results

A total of 17,265 LAP and 744 RARL procedures were identified. The RALR cases had significantly higher total cost ($5,272 increase, p < 0.001) and direct cost ($4,432 increase, p < 0.001), significantly longer operating time (39 min, p < 0.001), and were more likely to develop postoperative bleeding (odds ratio 1.6; p = 0.014) than traditional laparoscopic patients. LOS, complications, and discharge disposition were comparable. Similar findings were noted for both laparoscopic colonic and rectal surgery.

Conclusions

RALR had significantly higher costs and operative time than traditional LAP without a measurable benefit.

Keywords

Robotic surgery Laparoscopic surgery Healthcare utilization Surgical outcomes Colorectal surgery 

Notes

Acknowledgments

This study was completed with support from Lobat Hashemi from Covidien’s Healthcare Economics and Outcomes Research Department.

Disclosures

Drs. Keller, Senagore, Lawrence, Champagne, and Delaney have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Deborah S. Keller
    • 1
    Email author
  • Anthony J. Senagore
    • 2
  • Justin K. Lawrence
    • 1
  • Brad J. Champagne
    • 1
  • Conor P. Delaney
    • 1
  1. 1.Division of Colorectal Surgery, Department of Surgery, University Hospitals-Case Medical Center Case Western Reserve UniversityClevelandUSA
  2. 2.Division of Colorectal Surgery, Department of SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesUSA

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