Abstract
Abstract
Purpose
There has been a shift towards elective resection for recurrent or complicated diverticular disease to prevent recurrent episodes of diverticulitis. Our study aims to compare the outcomes in elective robotic and laparoscopic anterior resection for diverticular disease by a single surgeon experienced in both techniques.
Method
This is a retrospective study of patients who underwent elective anterior resections at the Nepean Public Hospital, Nepean Private Hospital, and Sydney Adventist Hospital (SAN) in the last 10 years. The single surgeon is an experienced surgeon who has performed laparoscopic anterior resections from January 2013 to December 2018; and mainly robotic anterior resections from January 2018 to July 2022.
The primary outcome of this study was to determine if there were any differences in length of stay and post-operative complications in laparoscopic and robotic anterior resections. Secondary outcomes included operating time, rate of conversion to open surgery, and 30-day mortality and morbidity.
Results
53 patients included in this study. There was no significant difference in conversion to open rates (p=0.528), mean operative time (p=0.095), stoma formation rates (p=0.528) and post-operative complication rates (0.609). Length of stay was significantly shorter in the robotic group (p=0.024), and a higher proportion of patients who had laparoscopic surgery stayed for ≥6 days (p=0.08). There were no anastomotic leakages, or 30-day mortality and morbidity.
Conclusion
Robotic anterior resection is a feasible approach in experienced hands and produces comparable results to laparoscopic anterior resection for diverticular disease in terms of length of stay, post-operative complications and operative timings.
Publisher
Research Square Platform LLC
Reference20 articles.
1. Complicated diverticulitis: is it time to rethink the rules?;Chapman J;Ann Surg,2005
2. Robotic versus conventional laparoscopic technique for the treatment of left-sided colonic diverticular disease: a systematic review with meta-analysis;Giuliani G;International Journal of Colorectal Disease,2022
3. Understanding the Value of Both Laparoscopic and Robotic Approaches Compared to the Open Approach in Colorectal Surgery;Hollis RH;Journal of laparoendoscopic & advanced surgical techniques. Part A,2016
4. Hettiarachchi, T.S., et al., Comparison of robotic vs laparoscopic left-sided colorectal cancer resections. Journal of robotic surgery, 2022.
5. Angehrn, F.V., et al., Robotic versus laparoscopic low anterior resection following neoadjuvant chemoradiation therapy for stage II–III locally advanced rectal cancer: a single-centre cohort study. Journal of robotic surgery, 2022.