ABSTRACT
Aim: To present an analysis of The first 2-years' experience of robotic-assisted Colorectal procedures (RACp) using The DaVinci Xi platform. Method(s): This data were prospectively collected and include 72 RACp between February 2020 and December 2021.Indications were: malignancy in 74.3%, diverticular disease 10%, inflammatory bowel disease 8.6%, rectal prolapse 4.3%, intussusception 1.4% and recurrent volvulus 1.4%. Result(s): Over The 13-month study period, 72 RACp were performed including elective 57 cases and 15 semi-elective cases. These comprised: 25 right hemicolectomies, 25 high anterior resections, 6 extended right hemicolectomies,4 low anterior resections, 4 subtotal colectomies 2 restorative proctectomies, 3 abdominoperineal excisions of The rectum, 3 rectopexies that were performed. 51.2% were female and 48.6% were male with a median age of 45 years (22-85 years) and The median body mass index was 31 (18-46) kg/m2. Preoperative American Society of Anaesthesiology scores were reported as 1-2 in 72.9% (n=51) of patients and 27.1%(n=19) as 3. The median length of stay was 5 days (1-35), with readmission rate within 30 days of 8.6% (n=6) that were resolved conservatively. The mean operating time was 268 minutes and The mean console operative time was 158 minutes, with only 3 (4.3%) reported cases of conversion to open. The incidence of postoperative complications was 24.3% (Clavien-Dindo (CD) I/II-12.9%, CD III-10%, and CD V-1 case with superimposed COVID 19 within 30 days. Conclusion(s): RACp is a safe and viable modality in The treatment of Colorectal conditions and can be introduced safely with appropriate guidance and proctorship.
ABSTRACT
Aim: To present our learning-curve data for patients that underwent robotic-assisted Colorectal Surgery (RCRS) at a large NE London DGH. Method(s):Wereport our data from50initial Colorectal Cancer resections, performed by two surgeons. We report The gender, age, histopathology, Surgery performed, surgical time, conversion, post-operative complications, and hospital stay. Result(s): The first 50 patients who underwent RCRS between February 2020 and December 2021 for malignancy were included. Twenty-one were right hemicolectomies, 16 high anterior resection, 6 extended right hemicolectomies, 4 low anterior resections (including a planned robotic boari flap in 1 case by a trained urologist), 3 abdominoperineal excisions of rectum. The male to female ratio was 1:1 and The mean age was 65 (range: 22-85) years. The ASA class distribution was 4% ASA I, 64% ASA II, 32% ASA III. The median surgical time was 263 minutes (120-620) with median console time 136 minutes (50-540), The median hospital stay 5 days (range: 2-35) and a conversion rate of 6% (3/50 patients). The most common post-operative complications were ileus 4% (4/50), wound infection 6% (3/50), anastomotic leak 6% (3/50), and abscess formation 2% (1/50). 1 mortality occurred in a patient with an operated leak who contracted COVID-19. All patients underwent confirmed RO resections with a negative CRM. Conclusion(s): We report our first 50 robotic cases for Colorectal malignancy, showing that robotic-assisted Surgery can be performed with low rates of conversion 3 cases (6%) and low rates of postoperative complications despite a challenging patient demographic and a sharp learning curve.