Right colectomy : a multicenter retrospective comparative study of robotic, laparoscopic and open approaches

Abstract

Minimally invasive surgery has revolutionised the way surgery is approached. Given the enormous amount of literature published about the benefits resulting from the laparoscopic cholecystectomy, this procedure is nowadays unanimously considered the “Gold Standard” for the treatment of gallstone disease. Several studies have been published since then, which demonstrates the role of minimally invasive surgery in the surgical treatment of right colic lesions, despite not determining such a huge historical leap as seen for the laparoscopic cholecystectomy. Despite been proven to be an effective technique, laparoscopic surgery had its limits. The introduction of robotic surgery was a way to overcome those limits. This paper is based on a multicenter retrospective study to assess the efficacy and safety of robotic surgery in the treatment of lesions affecting the right colon, when compared to both open and laparoscopic surgery. The two institutions that took part in the study were: the Clinical Surgery Unit – “Policlinico Vittorio Emanuele” University Hospital (Catania) and the General Surgery Unit – Sant’Agostino Estense Hospital (Modena). A total of 152 patients were collected from a prospectively maintained institutional database. Forty one patients underwent conventional open right colectomy (OS = open surgery), sixty-eight patients underwent total laparoscopic right colectomy (LS= laparoscopic surgery) and finally 43 patients underwent robotic-assisted right colectomy (RS = robotic surgery). Data was retrospectively analysed, in order to assess any statistically significant difference among these three approaches, regarding the following aspects: operative duration, surgical complication, time to first flatus, length of stay and number of lymph nodes harvested.