EP526 - Robotic versus laparoscopic approach in complicated diverticular disease: is robotic surgery the new standard?

Sunday, May 10, 2026

2:08 PM - 2:13 PM ET

ePoster Presenter(s)

JK

Jim Khan, MD

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Author(s)

CT

Christophe Taoum, n/a

Surgical Oncology Consultant
Montpellier Cancer Institute
Montpellier, Languedoc-Roussillon, France

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Author(s)

GP

Guglielmo Niccolò Piozzi, MD

Portsmouth Hospitals University NHS Trust

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GD

Gerald David, n/a

Consultant Department of colorectal surgery
Portsmouth Hospitals University NHS Trust
Portsmouth, England, United Kingdom

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FS

Filipos Sagias, n/a

Consultant Department of colorectal surgery
Portsmouth Hospitals University NHS Trust
Portsmouth, England, United Kingdom

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JR

John Richardson, n/a

Consultant Department of colorectal surgery
Portsmouth Hospitals University NHS Trust
Portsmouth, England, United Kingdom

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JC

John Conti, n/a

Consultant Department of colorectal surgery
Portsmouth Hospitals University NHS Trust
Portsmouth, England, United Kingdom

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Purpose/Background: Minimally invasive surgery (MIS) has become standard in colorectal practice, and robotic surgery is increasingly adopted for complex cases. However, its advantages over laparoscopy in complicated diverticulitis remain unclear. This study aimed to compare perioperative and postoperative outcomes between laparoscopic and robotic approaches in this setting.

Methods/Interventions: A retrospective single-center study was conducted from January 2012 to August 2025, including patients who underwent MIS for complicated diverticulitis, defined by abscess or perforation, bleeding, obstruction or stricture, and fistula. Demographic characteristics, surgical details, and postoperative outcomes were analyzed and compared between the laparoscopic (LG) and robotic (RG) groups.

Results/Outcomes: A total of 182 patients were included: 131 in the LG and 51 in the RG. Baseline characteristics were comparable, except for a higher rate of fistulas in LG (p = 0.032). Colovesical and colovaginal fistulas were similarly distributed between groups. Most procedures were elective (87.4%). Hartmann’s procedure was more frequent in LG (21.4% vs 7.8%, p = 0.031), while ureteral stenting was less common in RG (37.4% vs 3.9%, p < 0.001). The use of a protective stoma was significantly lower in RG compared with LG (79.8% vs 20.0%, p < 0.001). Conversion to open surgery occurred only in LG (9.9% vs 0%, p = 0.021). Blood loss was lower in RG (99.5 vs 20 cc, p < 0.001), and operative time was similar (260 vs 240 min, p = 0.721). Severe complications (Clavien–Dindo grade ≥ III) occurred in 5.5% of cases and were comparable between groups, as were anastomotic leak rates (11.1% vs 6.7%, p = 0.549). Length of stay (8 vs 6 days, p = 0.027) and 30-day readmission (18.3% vs 5.9%, p = 0.037) were significantly lower in RG. At one year, persistent stoma was significantly less frequent in RG (34.6% vs 17.0%, p = 0.026).

Conclusion/Discussion: These findings suggest that the robotic approach improves perioperative efficiency by lowering conversion and stoma rates, offering a safe and potentially more cost-effective option for managing complex diverticular disease.