Skip to main content
Log in

Comparison of robotically performed and traditional laparoscopic colorectal surgery

  • Published:
Diseases of the Colon & Rectum

Abstract

Robotic laparoscopic surgery is postulated to result in better surgical results by allowing improved instrument manipulation and three-dimensional vision. The authors’ experience performing robot-assisted laparoscopic colorectal surgery is reported. METHOD: Standard laparoscopic procedures with robot-assisted laparoscopic colon mobilization and vascular ligation were performed. Data relating to the operative procedure, hospital stay, and direct costs were collected. Results were compared with age, gender, and procedure case-matched controls taken from a prospective laparoscopic colorectal surgery database. RESULTS: Six robot-assisted laparoscopic surgeries (2 right hemicolectomies, 3 sigmoid colectomies, and 1 Wells rectopexy) were performed between December 2001 and June 2002. There was no associated morbidity. Operative time was increased from a median time of 108 minutes for standard laparoscopic colorectal surgery to 165 minutes for robot-assisted laparoscopic surgeries (P = 0.0313; Wilcoxon matched-pairs signed-rank test for non-parametric data). This was primarily a result of the time required for robot set-up. Blood loss, length of stay, and hospital cost were not significantly different between groups. Additional direct equipment costs for RAC cases included robotic laparoscopic instruments and sterile drapes (approximately US $350 per case), without including acquisition and maintenance costs for the robot. CONCLUSION: Robot-assisted laparoscopic colectomy is a feasible and safe procedure. Although three-dimensional vision and dexterity are facilitated, operative time is increased and the overall additional expense of robotics is of concern. Robot-assisted laparoscopic colectomy requires further evaluation to establish clinical and financial benefits before introduction to routine practice. Such techniques may, in the future, facilitate complex laparoscopic techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ballantyne GH. Editor’s introduction: the pitfalls of laparoscopic surgery: challenges for robotics and telerobotic surgery. Surg Laparosc Endosc 2002;12:l-5.

    Google Scholar 

  2. NIH consensus statement: gallstones and laparoscopic cholecystectomy. JAMA 1993;269:1018-24.

  3. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1991;l:144–50.

    Google Scholar 

  4. Fowler DC, White SA. Brief clinical report: laparoscopic-assisted sigmoid colectomy (abstract). Surg Laparosc Endosc 1991;1:183.

    PubMed  CAS  Google Scholar 

  5. Phillips EH, Franklin M, Carroll BJ,et al. Laparoscopic colectomy. Ann Surg 1992;2l6:703–7.

    Article  Google Scholar 

  6. Darzi A, Lewis C, Menzies-Gow N,et al. Laparoscopic abdominoperineal excision of the rectum. Surg Endosc 1995;9:4l4–7.

    Google Scholar 

  7. Duepree H-J, Senagore AJ, Delaney CP,et al. Advantages of laparoscopic resection for ileocecal Crohn’s disease. Dis Colon Rectum 2002;45:605–10.

    Article  PubMed  Google Scholar 

  8. Lo P, Ahmed N, Chung RS. Which laparoscopic operations are the fastest growing in residency programs (abstract)? Surg Endosc 2001;15(Sl):S145.

    Google Scholar 

  9. Darzi A, Mackay S. Recent advances in minimal access surgery. BMJ 2002;324:31–4.

    Article  PubMed  Google Scholar 

  10. Weeks JC, Nelson H, Gelber S,et al. Short-term quality-of-life outcomes following laparoscopic-assisted colec tomy vs open colectomy for colon cancer. JAMA 2002; 287:321–8.

    Article  PubMed  Google Scholar 

  11. Jacobs S, Falk V. Pearls and pitfalls: lessons learned in endoscopie robotic surgery—the da Vinci experience. Heart Surg Forum 2001;4:307–10.

    PubMed  CAS  Google Scholar 

  12. Falcone T, Goldberg JM, Margossian H,et al. Robotic-assisted laparoscopic microsurgical tubal anastomosis: a human pilot study. Fertil Steril 2000;73:1040–2.

    Article  PubMed  CAS  Google Scholar 

  13. Abbou CC, Hoznek A, Salomon L,et al. Laparoscopic radical prostatectomy with a remote controlled robot. J Urol 2001;l65:1964–6.

    Google Scholar 

  14. Cadière GB, Himpens J, Germay O,et al. Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 2001;25:1467–77.

    PubMed  Google Scholar 

  15. Merola S, Weber P, Wasielewski A,et al. Comparison of laparoscopic colectomy with and without the aid of a robotic camera holder. Surg Laparosc Endosc 2002;12:46–51.

    Article  Google Scholar 

  16. Weber PA, Merola S, Wasielewski A,et al. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 2002;45:l689–96.

    Article  Google Scholar 

  17. Falk V, Mintz D, Grünenfelder J,et al. Influence of three-dimensional vision on surgical telemanipulator performance. Surg Endosc 2001;15:1282–8.

    Article  PubMed  CAS  Google Scholar 

  18. Ruurda JP, Breeders IA, Simmermacher RP,et al. Feasibility of robot-assisted laparoscopic surgery: an evaluation of 35 robot-assisted laparoscopic cholecystectomies. Surg Laparosc Endosc 2002;12:4l-5.

    Article  Google Scholar 

  19. Ballantyne GH, Kelley WE. Granting privileges for telerobotic surgery. Surg Laparosc Endosc 2002;12:17–25.

    Article  Google Scholar 

  20. Wexner SD, Moscovitz ID. Laparoscopic colectomy in diverticular and Crohn’s disease. Surg Clin North Am 2000;80:1299–319.

    Article  PubMed  CAS  Google Scholar 

  21. Madbouly KM, Senagore AJ, Delaney CP,et al. Clinically based management of rectal prolapse. Surg Endosc 2002;Sep 30; [epub ahead of print].

  22. Senagore AJ, Whalley D, Delaney CP,et al. Epidural anesthesia/analgesia shortens length of stay after laparoscopic colectomy for benign pathology. Surgery 2001; 129:672–6.

    Article  PubMed  CAS  Google Scholar 

  23. Senagore AJ, Duepree HJ, Delaney CP,et al. Cost structure of laparoscopic and open sigmoid colectomy for diverticular disease: similarities and differences. Dis Colon Rectum 2002;45:485–90.

    Article  PubMed  Google Scholar 

  24. Chapman AE, Levitt MD, Hewett P,et al. Laparoscopic-assisted resection of colorectal malignancies: a systematic review. Ann Surg 2001;234:590–606.

    Article  PubMed  CAS  Google Scholar 

  25. Lacy AM, Garcia-Valdecasas JC, Delgado S,et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 2002;359:2224–9.

    Article  PubMed  Google Scholar 

  26. Petrelli NJ. Clinical trials are mandatory for improving surgical cancer care. JAMA 2002;287:377–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Delaney, C.P., Lynch, A.C., Senagore, A.J. et al. Comparison of robotically performed and traditional laparoscopic colorectal surgery. Dis Colon Rectum 46, 1633–1639 (2003). https://doi.org/10.1007/BF02660768

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02660768

Key words

Navigation