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Laparoscopic vs Robotic Surgery in Colorectal Cases
MATERIALS AND METHODS
Results were comparable in laparoscopic and robotic
The 14 studies included in the review article include
surgery. Only set-up time was longer in robotic
single-center and multicenter studies, randomized con-
No difference in intraoperative complications, blood loss, and postoperative pain. Operative time reduced in robotic cases with time and experience. No conversion to open surgery in robotic cases, two cases converted to open in laparoscopic cases Robotic surgery comparable to laparoscopic in world published during the period from 2001 to 2017. The
trolled trials (RCTs), as well as retrospective studies and
meta-analysis conducted in reputed institutes across the

research material for the review article was sourced from
Medline, PubMed, and Cochrane Central.

DISCUSSION

This review article deals with the comparison of laparo-
Conclusion surgery outcome scopic surgery and robotic surgery in colorectal cases and
has taken into account 14 articles which have a patient
subset ranging from 2000 to 2017 included in retrospec-
tive studies, case–control studies, and meta-analysis.
The data from the various studies have shown that
robotic colectomy can prove to be a safe and feasible
Total 263 patients of which 101 were robotic cases and 162 laparoscopic cases 22 patients underwent robotic (between March 2013 and December 2014) and 22 patients underwent laparoscopic (between December 2010 and February 2013) 131 patients underwent laparoscopic colorectal surgery and 96 underwent short-term outcomes of robotic colectomy have indeed
approach comparable to laparoscopic colectomy. The

6,7,15,16
been favorable.
17
Weber et al reported performing the first robotic
18
colonic resection using the Da Vinci system in 2001.
Since then, studies have been done on robotic colectomies
and also comparing laparoscopic and robotic colorectal
Patient subset robotic surgery surgeries. Previous studies have suggested an improved
conversion rate using robotic-assisted laparoscopic
resection over laparoscopic resection in rectal cancer
resections. 2,19-23 Recent meta-analyses have affirmed the
Retrospective case–control study from March 2010 to March 2012 for robotic and from January 2009 to December 2011 for laparoscopic cases Case–control studies for transverse PPD: Premiers Perspective Database; ACSNSQ: American College of Surgeons National Surgical Quality improvement project colectomy database after approximately 20 cases for robotic colectomy even
12-14
statistically significant difference.
It has been estimated that the learning curve is reached
for surgeons who lack significant laparoscopic experi-
24
ence. Because the robot affords improved visualization
and manipulation, facilitating precise dissection within
confines of bony pelvis, the use of robot-assisted resec-
Type of study colon adenocarcinoma Retrospective review tion for patients with rectal cancer has been increasing.
Many groups have described application of technology to
25
benign conditions like complicated diverticulitis also.
There are now several nonrandomized comparison
trials reporting lower conversion rates in robotic than in
laparoscopy surgery, even in patients with tumors less
Date of publication Feb 7, 2013 Oct 9, 2015 Apr 28, 2016 than 5 cm from the anal verge. 23,26,27 This is likely due
to the improved precision, retraction, and visualization
afforded by the robotic arms. Most studies report no
increase in complication rates including in anastomo-
10,11,14,29,30
sis leak.
Most significantly, robotic colectomy
10,11,27,29,30
The robotic vs laparoscopic resection for
surgery.
4,31
Multiple meta-
rectal cancer trial addresses this issue.
(Cont’d…) Name of author Neel M Helvind et al, 49 Copenhagen University Hospital, Denmark Nicola De Angelis et al, 50 Unit of digestive and HPB, Henri Mondor Hospital, Cretell, France Vanitha Vasudevan et al, 51 Centre for Advanced Surgical Oncology, Palmetto General Hospital, Florida, USA is associated with lower risk of conversion to open
analyses conclude that robotic surgery does not appear
to be associated with significantly longer operative times
than laparoscopy. A three-phase learning curve has been
World Journal of Laparoscopic Surgery, January-April 2018;11(1):43-47 45