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Outcomes in robotic-assisted compared to laparoscopic-assisted colorectal surgery in a newly established colorectal tertiary center: a retrospective comparative cohort study

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Abstract

The robotic platform matches or surpasses laparoscopic surgery in postoperative results. However, limited date and slow adoption are noticed in the middle east. We aimed to report outcomes of robotic and laparoscopic colorectal surgery performed by fellowship-trained robotic colorectal surgeons and compare it to larger more experienced centers. Retrospective review of prospectively collected data between 2021 and 2023 of 107 patients who had robotic-assisted or laparoscopic-assisted colorectal surgery was included in the study. The outcomes were overall morbidity, serious morbidity, mortality, conversion to open, length of hospital stay, and the quality of oncological specimen. Of 107 patients, 57 were in the robotic and 50 were in the laparoscopic surgery groups. Overall, there were no significant differences in overall morbidity (46.8 vs. 53.2%, p = 0.9), serious morbidity (10.5 vs. 8%, p = 0.7), or mortality (0 vs. 4%, p = 0.2). Regarding oncological outcomes, there were no significant difference between the two groups regarding the number of lymph node harvested (17.7 ± 6.9 vs 19.0 ± 9.7, p = 0.5), R0 resections (92.7 vs. 87.1%, p = 0.5), and the rate of complete mesorectal excision (92.7 vs. 71.4%, p = 0.19). The study found that the robotic group had an 86% reduction in conversion rate to open surgery compared to the laparoscopic group, despite including more obese and physically dependent patients (OR = 0.14, 95% CI 0.03–0.7, p = 0.01). Robotic surgery appears to be a safe and effective as laparoscopic surgery in smaller colorectal surgery programs led by fellowship-trained robotic surgeons, with outcomes comparable to those of larger programs.

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No datasets were generated or analysed during the current study.

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Funding

The authors declare that no funds, grants, or other supports were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, State of Kuwait, Kuwait City, Kuwait

    Ahmed Alkhamis & Salman Alsafran

  2. Colorectal and Robotics Surgery Unit, Department of Surgery, Jaber Al-Ahmed Hospital, State of Kuwait, Kuwait City, Kuwait

    Ahmed Alkhamis, Diaa Soliman, Ahmad Alrashed, Mohammad Alansari, Khaled Alsadder, Zeinab Chamkha, Bader AlShaban & Sulaiman Almazeedi

  3. Endocrine Surgery Unit, Department of Surgery, Jaber Al-Ahmed Hospital, State of Kuwait, Kuwait City, Kuwait

    Salman Alsafran

  4. Department of General Surgery, University of Arizona, Tucson, AZ, USA

    Diaa Soliman

  5. Department of Surgery, TriHealth Good Samaritan Hospital, Cincinnati, OH, USA

    Dante Souza

  6. Kuwait Institute for Medical Specialization, Ministry of Health, Kuwait City, Kuwait

    Omar Alkandari

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  1. Ahmed Alkhamis
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  10. Salman Alsafran
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Contributions

All authors contributed to the study conception and design: AA, DS, OA, AA, MA, KA, ZC, DS, BA, SA, and SA. Material preparation, data collection, and analysis were primarily undertaken by KA, AA, MA, ZC, and DS. The statistical analysis was expertly managed by OA. The first draft of the manuscript was authored by AA and DS. Both AA and DS played pivotal roles in editing, revising, and finalizing the manuscript. All authors provided crucial feedback, participated in revising subsequent drafts, and approved the final manuscript for publication.

Corresponding author

Correspondence to Ahmed Alkhamis.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was approved by Kuwait Ministry of Health Ethical Review Board (Ethical Approval No. 2228/2023).

Consent to participate

Given the observational nature of this study, which involved no disclosure of personal data, participant consent was not required. Therefore, no specific consent statements are included in the manuscript.

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Alkhamis, A., Soliman, D., Alkandari, O. et al. Outcomes in robotic-assisted compared to laparoscopic-assisted colorectal surgery in a newly established colorectal tertiary center: a retrospective comparative cohort study. J Robotic Surg 18, 152 (2024). https://doi.org/10.1007/s11701-024-01908-8

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