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Surgical and medical outcomes in robotic compared to laparoscopic colectomy global prospective cohort from the American college of surgeons national surgical quality improvement program

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Abstract

Background

Evidence regarding the outcomes benefits of robotic approach, when compared to a laparoscopic approach, in colectomy remain limited.

Objective

This study aimed to analyze the value of robotic approach compared to laparoscopic approach in minimally invasive colectomy.

Design

Cohort study of the National Surgical Quality Improvement Program (NSQIP).

Setting

This study included data from the NSQIP from 1/2016 to 12/2021.

Patient

Adult patients undergoing minimally invasive (laparoscopic or robotic) colorectal surgery.

Intervention

Robotic versus laparoscopic colectomy.

Outcome measures

Risk ratios for the incidence of medical and surgical morbidity and overall mortality.

Results

Compared to laparoscopic, robotic colectomy was associated with a significant decrease in postoperative morbidity [RR 0.84 (95%CI 0.72–0.96), P < 0.001], a significant reduction in postoperative mortality [RR 0.83 (95%CI 0.79–0.90), P 0.010)], and in post operative ileus [RR: 0.80 (95%CI 0.75–0.84), P < 0.001]. Yet, robotic approach was associated with a significant increase in total operative time despite a significant decrease in total length of stay. No benefit was observed regarding anastomotic leak.

Limitations

Observational nature of the study cannot exclude residual bias.

Conclusions

In this prospective cohort from the NSQIP, robotic colectomy was associated with a significant reduction in postoperative ileus, unplanned conversion to open surgery, morbidity, and overall mortality when compared to laparoscopic colectomy.

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Funding

This work has not received any funding.

Author information

Author notes

  1. Rodrigo Moisés de Almeida Leite and Sergio Eduardo Alonso Araujo are co-first authors.

Authors and Affiliations

  1. Colon and Rectal Surgery Department, Massachussets General Hospital, 15 Parkman Street, WACC 460, Boston, MA, 02114, USA

    Rodrigo Moisés de Almeida Leite & Rocco Ricciardi

  2. Staff Colorectal Surgeon and Medical Director, Oncology Division, Albert Einstein Israelite Hospital, São Paulo, Brazil

    Sergio Eduardo Alonso Araujo

  3. Department of Surgery, Massachussets General Hospital, Boston, MA, 02214, USA

    Christy Cauley, Rob Goldstone, Todd Francone & Rocco Ricciardi

  4. Intuitive Surgical, Sunnyvale, USA

    Hannah Bossie

  5. Gastrointestinal Surgery Division, University of Sao Paulo Medical School, São Paulo, Brazil

    Leandro Cardoso Barchi & Ulysses Ribeiro Jr.

  6. Faculdade de Medicina de Jundiaí, Jundiaí, Brazil

    Alexandre Venancio de Souza & Larissa Fagundes

  7. Colon & Rectal Surgery Resident, Albert Einstein Israelite Hospital, Sao Paulo, Brazil

    Rodrigo Moisés de Almeida Leite

  8. Albert Einstein Israelite Hospital, Sao Paulo, Brazil

    Gustavo Yano Callado

Authors
  1. Rodrigo Moisés de Almeida Leite
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  2. Sergio Eduardo Alonso Araujo
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  10. Ulysses Ribeiro Jr.
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  11. Hannah Bossie
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  12. Rocco Ricciardi
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Corresponding author

Correspondence to Rocco Ricciardi.

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Disclosures

Ms. Hannah Bossie works for Intuitive inc as a Medical Science Liaison and is a stockholder of the company. Ms Bossie did not participate in the statistical analysis or in the results/ conclusions sections of the manuscript. Dr Rodrigo Leite, Dr. Rocco Ricciardi, Dr. Sergio Eduardo Alonso Araujo, Mr. Gustavo Yano Callado, Dr. Alexandre Venancio de Souza, Dr. Robert Neil Goldstone, Dr. Todd Francone, Dr Leandro Barchi, Dr. Larissa Fagundes, Dr. Ulysses Ribeiro jr does not have any conflicts of interest to declare.

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de Almeida Leite, R.M., Araujo, S.E.A., de Souza, A.V. et al. Surgical and medical outcomes in robotic compared to laparoscopic colectomy global prospective cohort from the American college of surgeons national surgical quality improvement program. Surg Endosc 38, 2571–2576 (2024). https://doi.org/10.1007/s00464-024-10717-x

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  • DOI: https://doi.org/10.1007/s00464-024-10717-x

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