Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2015; 21(46): 13152-13159
Published online Dec 14, 2015. doi: 10.3748/wjg.v21.i46.13152
Totally robotic vs 3D laparoscopic colectomy: A single centers preliminary experience
Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Rosaria Gesuita, Roberto Ghiselli
Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy
Rosaria Gesuita, Center for Epidemiology and Biostatistics, Polytechnic University of Marche, 60121 Ancona, Italy
Author contributions: Guerrieri M, Campagnacci R, Sperti P, Belfiori G and Ghiselli R planned the study; Gesuita R analyzed data; Sperti P and Belfiori G performed the research and wrote the paper with Guerrieri M.
Institutional review board statement: The internal ethic committee approved this research.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Authors have no conflict of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Roberto Campagnacci, MD, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, Strada Passo Varano, 60131 Ancona, Italy. rcampagnacci@libero.it
Telephone: +39-71-5963320 Fax: +39-71-5963577
Received: May 9, 2015
Peer-review started: May 12, 2015
First decision: June 19, 2015
Revised: July 9, 2015
Accepted: September 14, 2015
Article in press: September 15, 2015
Published online: December 14, 2015
Processing time: 214 Days and 8.2 Hours
Abstract

AIM: To compare robotic and three-dimensional (3D) laparoscopic colectomy based on the literature and our preliminary experience.

METHODS: This retrospective observational study compared operative measures and postoperative outcomes between laparoscopic 3D and robotic colectomy for cancer. From September 2013 to September 2014, 24 robotic colectomies and 23 3D laparoscopic colectomy were performed at our Department. Data were analyzed and reported both by approach and by colectomy side. Robotic left colectomy (RL) vs laparoscopic 3D left colectomy (LL 3D) and Robotic right colectomy (RR) vs laparoscopic 3D (LR 3D). Rectal cancer procedures were not included.

RESULTS: There were 18 RR and 11 LR 3D, 6 RL and 12 LL 3D. As regards LR 3D, extracorporeal anastomosis (EA) was performed in 7 patients and intracorporeal anastomosis (IA) in 4; the RR group included 14 IA and 4 EA. There was no mortality. Median operative time was higher for the robotic group while conversion rate (12.5% vs 13%) and lymph nodes removed (14 vs 13) were similar for both. First flatus time was 1 d for RR and 2 d the other patient groups. Oral intake was resumed in 1 d by LR and in 2 d by the other patients (P = 0.012). Overall cost was €4950 and €1950 for RL and LL 3D, and €4450 and €1450 for RR and LR 3D, respectively.

CONCLUSION: There were no differences between RR and LR 3D, except that IA was easier with RR, and probably contributed with the learning curve to the longer operative time recorded. Both techniques offer similar advantages for the patient with significantly different costs. In left colectomies robotic colectomy provided better outcomes, especially in resections approaching the rectum.

Keywords: Three-dimensional vision systems; Robotic surgery; Laparoscopic surgery; Colectomy; Costs; Short-term outcomes

Core tip: Three-dimensional (3D) vision systems (Robotic and 3D laparoscopy) have been applied recently in the field of general colorectal surgery. They have brought a lot of benefits not only for the surgeon but also for the patient. However the robotic technique is very expensive, and no study has been published comparing these two techniques. Here, we compared robotic colorectal surgery to 3D laparoscopic with respect to short term outcomes and costs.