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Scientific article
Open access
English

Implementation of totally robotic right hemicolectomy: lessons learned from a prospective cohort

Published inJournal of robotic surgery, vol. 17, no. 5, p. 2315-2321
Publication date2023-10
First online date2023-06-21
Abstract

Robotics facilitates the realization of intra-corporeal anastomosis during right hemicolectomy and allows extracting the operative specimen through a C-section, offering potential benefits in terms of post-operative recovery and incidence of incisional hernia. Therefore, we progressively implemented robotic right hemicolectomy (robRHC) in our centre, and would like to report our initial experience with the technique. Consecutive patients who underwent robRHC within a single centre were prospectively included. Variables related to patients' demographics, surgical procedures, post-operative recovery and pathological outcomes were collected. Sixty patients underwent robRHC in our centre. Indications for robRHC were colon cancer in 58 patients (96.7%) and polyps not amenable to endoscopic resection in 2 patients (3.3%). Fifty-eight patients underwent robRHC with D2 lymphadenectomy and central vessel ligation (96.7%), and two patients (3.3%) had robRHC associated with another procedure. All patients had intra-corporeal anastomosis. The mean ± operative time was of 200.4 ± 114.9 min. Two conversions (3.3%) to open surgery were performed. The mean ± SD length of stay was of 5.4 ± 3.8 days. Seven patients (11.7%) experienced a post-operative complication with a Clavien-Dindo score ≥ 2. Two patients (3.5%) had an anastomotic leak. The mean ± SD number of harvested lymph nodes was of 22.4 ± 7.6. All patients had negative pathological margins (R0 resection). To conclude, robotic RHC is a safe procedure, which can be implemented with satisfying peri- and post-operative outcomes. The potential benefits of the technique remain to be demonstrated by randomized controlled trials.

eng
Keywords
  • Colon cancer
  • Colorectal cancer
  • MIS
  • RHC
  • Robotic surgery
  • Colectomy / methods
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery
  • Humans
  • Laparoscopy / methods
  • Prospective Studies
  • Retrospective Studies
  • Robotic Surgical Procedures / methods
  • Robotics
  • Treatment Outcome
Citation (ISO format)
MEYER, Jeremy et al. Implementation of totally robotic right hemicolectomy: lessons learned from a prospective cohort. In: Journal of robotic surgery, 2023, vol. 17, n° 5, p. 2315–2321. doi: 10.1007/s11701-023-01646-3
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Article (Published version)
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ISSN of the journal1863-2483
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