EP677 - Robotic vs Laparoscopic Right Hemicolectomy: Outcomes and Costs in a Community Setting

Purpose/Background: Minimally invasive right hemicolectomy has become standard for benign and malignant colonic disease. While both laparoscopic and robotic techniques are widely utilized, comparative data on perioperative outcomes, postoperative recovery, and cost in non-tertiary settings are limited. This study analyzes a single community hospital's 10-year experience with both approaches.

Methods/Interventions: A retrospective observational study was conducted of all consecutive patients undergoing right hemicolectomy between 2015 and 2024 at a community hospital. A total of 56 patients were included in the analysis. Perioperative outcomes, complication rates, postoperative care utilization, and hospital costs were compared between laparoscopic and robotic approaches.

Results/Outcomes: Patients were similar in age (mean 74 vs 72, p = 0.62), sex distribution (46% vs 41% male, p = 0.70), and BMI (24.7 vs 25.4, p = 0.92) in the laparoscopic versus robotic groups, respectively. Robotic procedures were associated with a significantly shorter hospital stay (2.0 days [2.0-2.25] vs 4.5 days [3.0-8.0], p < 0.001) but required longer operative times (145.0 min [126.5-157.0] vs 76.0 min [65.8-117.3], p < 0.001). Postoperative complication rates were lower in the robotic group (6.2% vs 33.3%, p = 0.013), and robotic cases were more frequently performed electively (93.8% vs 62.5%, p = 0.003). None of the robotic cases required ICU admission, compared to 16.7% of laparoscopic cases (p = 0.029). Cost analysis showed that the median total cost for laparoscopic procedures was higher ($11,741.82 vs $10,421.66), though this difference was not statistically significant (p = 0.095). Physician costs were significantly higher for laparoscopic cases (p < 0.0001), while purchase service costs (e.g., robotic maintenance) were significantly higher in the robotic group (p = 0.0062).

Conclusion/Discussion: In a community hospital setting, robotic right hemicolectomy was associated with shorter hospitalization, fewer complications, and less need for intensive care, despite longer operative times. Total hospital costs were comparable between approaches, though cost distribution differed, with laparoscopic cases incurring higher physician fees and robotic cases higher service costs. These findings support robotic colectomy as a safe, effective, and resource-conscious alternative to laparoscopy in non-tertiary settings.