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A review of clinical and oncological outcomes following the introduction of the first robotic colorectal surgery programme to a university teaching hospital in Ireland using a dual console training platform

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Abstract

Robotic-assisted surgery is evolving, with improving clinical and cancer outcomes. The aim of this study was to present the clinical and cancer outcomes of patients undergoing robotic-assisted colorectal surgery (RAS-CR) at University Hospital Limerick (UHL) since its introduction to the 100th case, using the daVinci Xi dual-console surgical system. The RAS-CR programme at UHL commenced in June 2016 and the 100th case was performed in July 2019. All patient-related data were recorded prospectively during the perioperative period by the RAS-CR team. Statistical analysis was performed using SPSS, version 22. One hundred patients were operated on, comprising of 47 males and 53 females. The median age was 65 years (IQR 13.0; range 25–84) with 69% of cases performed for cancer [N = 39 rectal cancer, N = 30 colon cancer], 20% for benign disease and 11% for dysplasia. Median length of stay for cancer operations was 6.5 days for colon cancer cases (5.0 days when cases with complications were excluded) and 7.0 days for rectal cancer cases. Median operative time was 255 mins (IQR 130 min; all cases), median docking time was 33 mins (IQR 20 mins) and median intra-operative blood loss was 80 ml (IQR 70 ml). Thirty-one patients developed a post-operative complication (5% anastomotic leak; 13% SSI). In cancer cases, median nodal harvest was 14 nodes (IQR10) and an R0 resection was achieved in 98.6% (n = 68) of cancer cases. Three patients (4.3%) developed metastatic disease at a median interval of 16.5 months. Clinical and operative outcomes remained stable over time from case 1 to 100. Structured introduction of a RAS-CR programme with appropriate governance and continuous audit results in favourable clinical and cancer outcomes and provides an excellent training opportunity for surgical residents.

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Acknowledgements

I would like to acknowledge the dedicated work of all members of the robotic-assisted surgery programme at University Hospital Limerick for their contribution to the clinical practice upon which this manuscript is based.

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Authors and Affiliations

  1. Department of Colorectal Surgery, University Hospital Limerick, Limerick, Ireland

    Christina A. Fleming, Daniel Westby, Mohammad Fahad Ullah, Helen M. Mohan, Rishabh Sehgal, Jarlath C. Bolger, Donal P. O’Leary, Emma McNamara, Eoghan Condon, John Calvin Coffey & Colin Peirce

  2. Department of Medical Oncology, University Hospital Limerick, Limerick, Ireland

    Grzegorz Korpanty

  3. Department of Radiation Oncology, University Hospital Limerick, Limerick, Ireland

    Mazen El Bassiouni

  4. Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation and Immunity [4i], University of Limerick, Limerick, Ireland

    John Calvin Coffey & Colin Peirce

Authors
  1. Christina A. Fleming
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  2. Daniel Westby
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  3. Mohammad Fahad Ullah
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  4. Helen M. Mohan
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  5. Rishabh Sehgal
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  6. Jarlath C. Bolger
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  7. Donal P. O’Leary
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  8. Emma McNamara
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  9. Grzegorz Korpanty
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  10. Mazen El Bassiouni
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  11. Eoghan Condon
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  12. John Calvin Coffey
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  13. Colin Peirce
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Corresponding author

Correspondence to Christina A. Fleming.

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Conflict of interest

Christina A Fleming, Daniel B Westby, Muhammad F Ullah, Helen M Mohan, Rishabh Sehgal, Jarlath C Bolger, Donal P O’Leary, Emma McNamara, Grzegorz Korpanty, Mazen El Bassiouni, Eoghan Condon, J Calvin Coffey, Colin Peirce declares that s/he has no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Fleming, C.A., Westby, D., Ullah, M.F. et al. A review of clinical and oncological outcomes following the introduction of the first robotic colorectal surgery programme to a university teaching hospital in Ireland using a dual console training platform. J Robotic Surg 14, 889–896 (2020). https://doi.org/10.1007/s11701-020-01073-8

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  • DOI: https://doi.org/10.1007/s11701-020-01073-8

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