Robotic Assistance in Right Hemicolectomy: Is There a Role?

摘要

PURPOSE: The purpose of this study was to evaluate the results, postoperative outcomes, and cost of robotic assistance in right hemicolectomy and determine its safety, feasibility, and efficacy as compared with the conventional laparoscopic approach. METHODS: From August 2005 to February 2009, 40 robot-assisted right hemicolectomies were performed by the authors at a single institution. These were compared with 135 laparoscopic right hemicolectomies performed by the authors, at the same hospital and during the same time period. Cost data from July 2006 until the end of the study period were compared between the 2 groups. RESULTS: Both groups were comparable with respect to age, sex, body mass index, American Society of Anesthesiologists' class, history of prior abdominal surgery, and diagnosis. There was no significant difference in the lymph node harvest, estimated blood loss, conversion rate, length of stay, or incidence of complications and wound infection between the 2 groups. A robotic procedure was associated with a longer operative time (P < .001) and a higher cost (P = .003). CONCLUSION: Robotic assistance in right hemicolectomy is safe and feasible but is associated with a longer operative time and, at present, with a higher cost compared with laparoscopy. However, right hemicolectomy serves as an ideal procedure to begin the learning curve in robotic colorectal surgery, which can subsequently progress to robotic rectal resections where the robot has the greatest potential for benefit.