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Robotics confers an advantage in right hemicolectomy with intracorporeal anastomosis when matched against conventional laparoscopy

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Abstract

Comparisons between robotic and laparoscopic right hemicolectomy have been confounded by variations in operative technique. This study evaluates the two procedures after standardizing the intraoperative steps and perioperative management. Patients who underwent robotic right hemicolectomy with intracorporeal bowel anastomosis between July 2015 and June 2017 were matched with a laparoscopic group. Perioperative management was in accordance to an enhanced recovery protocol. Outcomes and histopathological data were compared. Thirty-two patients were included. Amongst the patients who did not undergo complete mesocolic excision, the median operative time did not differ between the two groups (p = 0.413). The robotic group recorded a statistically shorter time for intracorporeal anastomosis (13 vs 19 min, p = 0.024). Postoperative recovery and complication rates were similar, except for a greater lymph node harvest in the robotic group (41 vs 31, p = 0.038). Robotic surgery achieves short-term results comparable to existing conventional laparoscopy, notwithstanding the advantages of enhanced ergonomics.

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References

  1. Young-Fadok TM, Nelson H (2000) Laparoscopic right colectomy: five-step procedure. Dis Colon Rectum 43:267–271

    Article  CAS  Google Scholar 

  2. Senagore AJ, Delaney CP, Brady KM, Fazio VW (2004) Standardized approach to laparoscopic right colectomy: outcomes in 70 consecutive cases. J Am Coll Surg 5:675–679

    Article  Google Scholar 

  3. The Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059

    Article  Google Scholar 

  4. Hellan M, Anderson C, Pigazzi A (2009) Extracorporeal versus intracorporeal anastomosis for laparoscopic right hemicolectomy. J Soc Laparosc Surg 13:312–317

    Google Scholar 

  5. Scatizzi M, Kroning KC, Borrelli A, Andan G, Lenzi E, Feroci F (2010) Extracorporeal versus intracorporeal anastomosis after laparoscopic right colectomy for cancer: a case-control study. World J Surg 34:2902–2908

    Article  Google Scholar 

  6. deSouza A, Domajnko B, Park J, Marecik S, Prasad L, Abcarian H (2011) Incisional hernia, midline versus low transverse incision: what is the ideal incision for specimen extraction and hand-assisted laparoscopy? Surg Endosc 25:1031–1036

    Article  Google Scholar 

  7. Samia H, Lawrence J, Nobel T, Stein S, Champagne BJ, Delaney CP (2013) Extraction site location and incisional hernias after laparoscopic colorectal surgery: should we be avoiding the midline? Am J Surg 205(3):264–268

    Article  Google Scholar 

  8. Benlice C, Stocchi L, Costedio MM, Gorgun E, Kessler H (2016) Impact of the specific extraction-site location on the risk of incisional hernia after laparoscopic colorectal resection. Dis Colon Rectum 59(8):743–750

    Article  Google Scholar 

  9. Jamali FR, Soweid AM, Dimassi H, Bailey C, Leroy J, Marescaux J (2008) Evaluating the degree of difficulty of laparoscopic colorectal surgery. Arch Surg 143(8):762–767

    Article  Google Scholar 

  10. Stein SA, Bergamaschi R (2013) Extracorporeal versus intracorporeal ileocolic anastomosis. Tech Coloproctol 17(Suppl 1):S35–S39

    Article  Google Scholar 

  11. Morpurgo E, Contardo T, Molaro R, Zerbinati A, Orsini C, D’Annibale A (2013) Robotic-assisted intracorporeal anastomosis versus extracorporeal anastomosis in laparoscopic right hemicolectomy for cancer: a case control study. J Laparoendosc Adv Surg Tech A 23(5):414–417

    Article  Google Scholar 

  12. Trastulli S, Desiderio J, Farinacci F et al (2013) Robotic right colectomy for cancer with intracorporeal anastomosis: short-term outcomes from a single institution. Int J Colorectal Dis 28(6):807–814

    Article  Google Scholar 

  13. Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196

    Article  Google Scholar 

  14. Park SY, Choi G, Park JS, Kim HJ, Choi W, Ryuk JP (2012) Robot-assisted right colectomy with lymphadenectomy and intracorporeal anastomosis for colon cancer: technical considerations. Surg Laparosc Endosc Percutan Tech 22:e271–e276

    Article  Google Scholar 

  15. Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1(3):144–150

    CAS  PubMed  Google Scholar 

  16. Guillou PJ, Quirke P, Thorpe H et al (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726

    Article  Google Scholar 

  17. Jayne DG, Guillou PJ, Thorpe H et al (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25:3061–3068

    Article  Google Scholar 

  18. Green BL, Marshall HC, Collinson F et al (2013) Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg 100:75–82

    Article  CAS  Google Scholar 

  19. Color, II Study Group (2015) A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med 372:1324–1332

    Article  Google Scholar 

  20. Memon S, Heriot AG, Murphy DG, Bressel M, Lynch AC (2012) Robotic versus laparoscopic proctectomy for rectal cancer: a meta-analysis. Ann Surg Oncol 19:2095–2101

    Article  Google Scholar 

  21. Liao G, Zhao Z, Lin S et al (2014) Robotic-assisted versus laparoscopic colorectal surgery: a meta-analysis of four randomized controlled trials. World J Surg Oncol 12:122

    Article  Google Scholar 

  22. Aly EH (2014) Robotic colorectal surgery: summary of the current evidence. Int J Colorectal Dis 29:1–8

    Article  CAS  Google Scholar 

  23. Zhang X, Wei Z, Bie M, Peng X, Chen C (2016) Robot-assisted versus laparoscopic-assisted surgery for colorectal cancer: a meta-analysis. Surg Endosc 30(12):5601–5614

    Article  Google Scholar 

  24. Weber PA, Merola S, Wasielewski A, Ballantyne GH (2002) Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 45:1689–1696

    Article  Google Scholar 

  25. Hohenberger W, Weber K, Metzel K, Papadopoulos T, Merkel S (2009) Standardized surgery for colonic cancer: complete mesocolic excision and central ligation—technical notes and outcome. Colorectal Dis 11:354–365

    Article  CAS  Google Scholar 

  26. West NP, Hohenberger W, Weber K, Perrakis A, Finan PJ, Quirke P (2012) Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol 28(2):272–278

    Article  Google Scholar 

  27. Killeen S, Mannion M, Devaney A, Winter DC (2014) Complete mesocolic resection and extended lymphadenectomy for colon cancer: a systematic review. Colorectal Dis 16:577–594

    Article  CAS  Google Scholar 

  28. Melich G, Jeong DH, Hur H et al (2014) Laparoscopic right hemicolectomy with complete mesocolic excision provides acceptable perioperative outcomes but is lengthy—analysis of learning curves for a novice minimally invasive surgeon. Can J Surg 57(5):331–336

    Article  Google Scholar 

  29. D’Annibale A, Morpurgo E, Fiscon V et al (2004) Robotic and laparoscopic surgery for treatment of colorectal diseases. Dis Colon Rectum 47:2162–2168

    Article  Google Scholar 

  30. De Souza AL, Prasad L, Park JJ, Marecik SJ, Blumetti J, Abcarian H (2010) Robotic assistance in right hemicolectomy: is there a role? Dis Colon Rectum 53:1000–1006

    Article  Google Scholar 

  31. D’Annibale A, Pernazza G, Morpurgo E et al (2010) Robotic right colon resection: evaluation of first 50 consecutive cases for malignant disease. Ann Surg Oncol 17:2856–2862

    Article  Google Scholar 

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Acknowledgements

Ms Yang Pei Leng from Transmedic Pte Ltd Singapore provided console training and technical support to the team.

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Correspondence to James Chi-Yong Ngu.

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Dr. James Ngu and Dr. Yvonne Ng declare that they have no conflict of interest. All authors are in agreement with the content of the manuscript. The manuscript has not been published previously and is not under consideration elsewhere.

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Ngu, J.CY., Ng, Y.YR. Robotics confers an advantage in right hemicolectomy with intracorporeal anastomosis when matched against conventional laparoscopy. J Robotic Surg 12, 647–653 (2018). https://doi.org/10.1007/s11701-018-0793-6

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  • DOI: https://doi.org/10.1007/s11701-018-0793-6

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