ROBOTIC VERSUS LAPAROSCOPIC LOW ANTERIOR RESECTION: RESULTS FROM A PROSPECTIVE COHORT STUDY

Introduction The Robotic approach in Low Anterior Resection (LAR) for the Surgical Treatment of Rectal cancer may be associated with improved postoperative outcomes, such as shorter recovery time and reduced incidence of postoperative complications. However, longer operative times and higher costs may also be associated when compared to laparoscopic approach. We analyzed a single surgeon prospective database comparing postoperative and intraoperative outcomes of LAR between robotic and laparoscopic approaches.

Methods We built a prospective cohort study including laparoscopic and robotic LAR for the treatment of low and middle rectal cancer. Summary of outcomes include: - Total Operative Time (in minutes); - Length of in-hospital stay (in days); - Incidence of Anastomotic Leak ; - Rate of unplanned conversions to open surgery; - Rate of any postoperative surgical complication. The statistical analysis was conducted on STATA 18 Standard Edition. 101 cases (66 robotic and 35 laparoscopic) were included for analysis. Robotic approach when compared to laparoscopy was associated with: - No increase in operative time (median 197 minutes {IQR 180-240} vs 200 minutes {IQR 180-240}. p 0.628) - Significant reduction in length of in-hospital stay (5 days vs 3 days), p 0.025 - Significant reduction in unplanned conversions (4.54% vs 20%), p 0.010 - Significant reduction in postoperative complications (RR 0.38, 95%CI {0.17-0.86}, p 0.018). No benefit was observed regarding anastomotic leak.

Results In this prospective, single center, cohort study, robotic approach in LAR with TME was associated with a shorter in-hospital stay, reduced conversions and postoperative complications without increase in operative time when compared to laparoscopy.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025