Cawich SO, Plummer JM, Griffith S, Naraynsingh V. Colorectal resections for malignancy: A pilot study comparing conventional vs freehand robot-assisted laparoscopic colectomy. World J Clin Cases 2024; 12(3): 488-494 [PMID: 38322459 DOI: 10.12998/wjcc.v12.i3.488]
Corresponding Author of This Article
Shamir O Cawich, FACS, Professor, Department of Surgery, University of the West Indies, St. Augustine Campus, St Augustine, Trinidad and Tobago. socawich@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
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/
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
ARTICLE HIGHLIGHTS
Research background
There is limited experience with robotics in surgery in the English-speaking Caribbean, although the laparoscopic approach to colorectal surgery is widely accepted for colorectal cancer. We recount our experience since the FreeHand robotic camera holder was introduced to the Caribbean in 2021.
Research motivation
In the English-speaking Caribbean, we experienced resistance to the introduction of the FreeHand® robotic camera holder to augment laparoscopic colorectal surgery. Therefore, we attempted to collect data to compare the initial results between conventional and FreeHand® robot-assisted laparoscopic colectomy in Trinidad and Tobago.
Research objectives
The aim of this study was to collect objective outcome data to compare robot-assisted and conventional laparoscopic colorectal resections for malignancy. The objectives were achieved and show that there is some advantage that requires further research in the future.
Research methods
A prospective study was carried out to collect data on the outcomes from all laparoscopic colectomies performed for colorectal carcinoma over a six-month period in Trinidad and Tobago. An independent observer recorded operating times, conversions, estimated blood loss, hospitalization, morbidity, surgical resection margins and number of nodes harvested. SPSS version 20 was used to analyze all data.
Research results
Of 23 colectomies performed for malignant disease, 8 (35%) were performed with the FreeHand® robot and 15 (65%) by conventional laparoscopy. 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.
Research conclusions
We have demonstrated that the FreeHand® robot for colectomies is safe, provides some advantages over conventional laparoscopy and does not compromise oncologic standards.
Research perspectives
This preliminary study suggests that operating time can significantly be reduced with the use of the FreeHand robot. This will guide future research. If larger studies confirm this finding, there will be significant implications for cost-savings in this setting. This will have significant positive implications for use of technology in low and middle income nations.
