Published online Jan 26, 2024. doi: 10.12998/wjcc.v12.i3.488
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
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.
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.
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.
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.
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.
We have demonstrated that the FreeHand® robot for colectomies is safe, provides some advantages over conventional laparoscopy and does not compromise oncologic standards.
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.