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Robotic versus laparoscopic right hemicolectomy: a retrospective cohort study of the Binational Colorectal Cancer Database

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Abstract

Robotic right hemicolectomy (RRC) may have technical advantages over the conventional laparoscopic right colectomy (LRC) due to higher degrees of rotation, articulation, and tri-dimensional imaging. There is growing literature describing advantages of RRC compared to LRC; however, there is a lack of evidence about safety, oncologic quality of surgery and cost. This study aimed to analyse complication rates, length of stay and nodal harvest in patients undergoing minimally invasive right hemicolectomy for colon cancer from a prospective Australasian colorectal cancer database. This was a retrospective cohort study using nearest neighbour matching. The Binational Colorectal Cancer Audit (BCCA) provided the data for analysis. The primary outcome was length of stay. Secondary outcomes were harvested lymph node count, anastomotic leak, postoperative haemorrhage, abdominal abscess, postoperative ileus, wound infections and non-surgical complications. 4977 patients who underwent robotic (n = 146) or laparoscopic (n = 4831) right hemicolectomy for right-sided colon cancer were included. For RRC, LOS was shorter (5 vs 6.9 days, p = 0.01) and nodal harvest was higher (22 vs 19, p = 0.04). For RRC, surgical complications (5.9% vs 14.2%, p < 0.004) and non-surgical complications (4.6% vs 11.7%, p = 0.007) were lower though there was no difference in return to theatre or inpatient death. Robotic right hemicolectomy is associated shorter LOS and marginally higher lymph node count, though this may reflect anastomotic technique rather than surgical platform. Longer term studies are required to establish differences in overall survival, incisional hernia rates and cost effectiveness.

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Acknowledgements

The authors would like to thank BCCA Project manager Dr Hayat Dagher for assistance obtaining data for this study.

Funding

The corresponding author is not the recipient of a research scholarship for this work.

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Authors and Affiliations

  1. Department of Surgery, Austin Health, Heidelberg, Melbourne, VIC, 3084, Australia

    Edward M. Clarke, Jessica Rahme & Philip Smart

  2. Department of Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia

    Tomas Larach & Satish Warrier

  3. General Surgery and Gastroenterology Clinical Institute, Epworth HealthCare, Richmond, Melbourne, VIC, 3121, Australia

    Amrish Rajkomar, Satish Warrier & Philip Smart

  4. Department of Surgery, Eastern Health, Box Hill, Melbourne, VIC, 3128, Australia

    Anshini Jain

  5. Translational Obstetrics Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, 3010, Australia

    Richard Hiscock

  6. Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Melbourne, VIC, 3084, Australia

    Richard Hiscock

Authors
  1. Edward M. Clarke
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  2. Jessica Rahme
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  3. Tomas Larach
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  4. Amrish Rajkomar
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  5. Anshini Jain
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  6. Richard Hiscock
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  7. Satish Warrier
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  8. Philip Smart
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Contributions

EC: data curation, writing—original draft, writing—review and editing. JR: data curation, writing—review and editing. TL: data curation, writing—review and editing. AR: data curation, writing—review and editing. AJ: data curation, writing—review and editing. RH: writing—original draft, data curation, formal analysis, methodology, writing—review and editing. SW: data curation, writing—review and editing. PS—supervision, conceptualization, writing—original draft.

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Correspondence to Edward M. Clarke.

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Conflict of interest

Dr Edward Clarke, Dr Jessica Rahme, Dr Tomas Larach, Dr Amrish Rajkomar, Dr Anshini Jain, Dr Richard Hiscock, Mr Satish Warrier and Dr Philip Smart declare that they have no conflict of interest.

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Clarke, E.M., Rahme, J., Larach, T. et al. Robotic versus laparoscopic right hemicolectomy: a retrospective cohort study of the Binational Colorectal Cancer Database. J Robotic Surg 16, 927–933 (2022). https://doi.org/10.1007/s11701-021-01319-z

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  • DOI: https://doi.org/10.1007/s11701-021-01319-z

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