COMMENTARY

Robot-Assisted vs Laparoscopic Colectomy

Albert B. Lowenfels, MD

Disclosures

November 30, 2012

Randomized Clinical Trial of Robot-Assisted Versus Standard Laparoscopic Right Colectomy

Park JS, Choi GS, Park SY, Kim HJ, Ryuk JP
Br J Surg. 2012;99:1219-1226

Summary

Is robotic right hemicolectomy superior to a laparoscopic procedure for treatment of right-sided colon cancer? The study authors randomly assigned 70 patients to these 2 different treatment options, with length of hospitalization as the main endpoint. Length of stay was similar in the 2 groups: 7.9 days in the robotic group compared with 8.3 days in the laparoscopic group (P = .13). Estimated operative time was more than an hour longer in the robotic group (P < .001) and the estimated total cost in US dollars was about $2000 higher in the robotic group. The pathologic findings, including proximal and distal margins and number of lymph nodes removed, were similar in the 2 groups.

Viewpoint

This study of immediate outcome after a commonly performed surgical gastrointestinal procedure showed no early advantage for robotic compared with laparoscopic surgery. The study was performed in the United Kingdom, so the cost difference would likely be much greater in the United States. The trial results were informative in that the robotic procedure was as safe as the laparoscopic procedure, and no patient required conversion to an open procedure in either group. Long-term results were not included, but the similar pathologic findings in the 2 groups suggest that survival will likely be similar. As the authors pointed out, robotic surgery may be best suited for more delicate operations where the emphasis is on careful control of dissection.

Abstract

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