Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2024; 12(3): 488-494
Published online Jan 26, 2024. doi: 10.12998/wjcc.v12.i3.488
Colorectal resections for malignancy: A pilot study comparing conventional vs freehand robot-assisted laparoscopic colectomy
Shamir O Cawich, Joseph Martin Plummer, Sahle Griffith, Vijay Naraynsingh
Shamir O Cawich, Department of Surgery, University of the West Indies, St Augustine, Trinidad and Tobago
Joseph Martin Plummer, Department of General Surgery and Consultant General and Colorectal Surgeon, Department of Surgery, University of the West Indies, Kingston, KIN7, Jamaica
Sahle Griffith, Department of Surgery, Queen Elizabeth Hospital, Bridgetown, Barbados
Vijay Naraynsingh, Department of Surgery, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago
Author contributions: Cawich SO conceptualized the research project, wrote the paper and checked for scientific accuracy; Plummer JM collected data and checked the manuscript for scientific accuracy; Griffith S collected data, performed statistical analyses and checked the manuscript for scientific accuracy; Naraynsingh V collected data, performed statistical analyses and checked the manuscript for scientific accuracy.
Institutional review board statement: This study was approved by the local institutional review board at the University of the West Indies (CREC-SA.1615/06/2022). A copy of the approval document will be provided upon request.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: There are no conflicts of interest for any of the authors of this study.
Data sharing statement: All data are kept by the corresponding author and can be released upon reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shamir O Cawich, FACS, Professor, Department of Surgery, University of the West Indies, St. Augustine Campus, St Augustine, Trinidad and Tobago. socawich@hotmail.com
Received: September 26, 2023
Peer-review started: September 26, 2023
First decision: December 5, 2023
Revised: December 6, 2023
Accepted: December 29, 2023
Article in press: December 29, 2023
Published online: January 26, 2024
Processing time: 114 Days and 7.8 Hours
Abstract
BACKGROUND

Laparoscopic colectomy is widely accepted as a safe operation for colorectal cancer, but we have experienced resistance to the introduction of the FreeHand® robotic camera holder to augment laparoscopic colorectal surgery.

AIM

To compare the initial results between conventional and FreeHand® robot-assisted laparoscopic colectomy in Trinidad and Tobago.

METHODS

This was a prospective study of outcomes from all laparoscopic colectomies performed for colorectal carcinoma from November 29, 2021 to May 30, 2022. The following data were recorded: Operating time, conversions, estimated blood loss, hospitalization, morbidity, surgical resection margins and number of nodes harvested. All data were entered into an excel database and the data were analyzed using SPSS ver 20.0.

RESULTS

There were 23 patients undergoing colectomies for malignant disease: 8 (35%) FreeHand®-assisted and 15 (65%) conventional laparoscopic colectomies. There were no conversions. Operating time was significantly lower in patients undergoing robot-assisted laparoscopic colectomy (95.13 ± 9.22 vs 105.67 ± 11.48 min; P = 0.045). Otherwise, there was no difference in estimated blood loss, nodal harvest, hospitalization, morbidity or mortality.

CONCLUSION

The FreeHand® robot for colectomies is safe, provides some advantages over conventional laparoscopy and does not compromise oncologic standards in the resource-poor Caribbean setting.

Keywords: Laparoscopic, Colectomy, Robot, Surgery, Minimally invasive

Core Tip: The FreeHand® single arm robot is a viable option to conventional laparoscopy for colorectal surgery. The Free hand robot is safe for colectomy and does not compromise oncologic standards in the resource-poor Caribbean setting.