Introduction of Robotic Surgery into a Community Hospital Setting: A Prospective Comparison of Robotic and Open Colorectal Resection for Cancer

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Purpose: The aim of this study was to compare robotic colorectal surgery (RCS) performed by a team having limited expertise in robotic surgery with open colorectal surgery (OCS) performed by experienced colorectal surgeons. Methods: This was a prospective comparative nonrandomized study. Results: Between March 2013 and June 2015, 79 patients with colon and rectal adenocarcinoma were enrolled into the study. Of these, 41 patients underwent OCS and 38 underwent RCS. The groups were comparable in terms of demographics and type of procedure. The RCS took significantly longer in the operating room than the OCS (222 vs. 141 min, p < 0.001). The rate of major complications was similar for both RCS and OCS (5.3 vs. 9.8%, p = 0.454). Wound infections were less frequent in the RCS group (10.5 vs. 29.3%, p = 0.039). The mean hospital stay was 1 day shorter in the RCS group than in the OCS group (5.7 vs. 6.7 days, p = 0.176). The lymph nodes harvested was comparable (14.7 RCS vs. 15.5 OCS, p = 0.596). Conclusions: This study confirmed that the surgical team with limited expertise in minimally invasive surgery can still safely introduce robotic surgery into their colorectal practice. When compared to the open approach, the robotic approach reduces hospital stay, as well as the rate of surgical site infection.

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