EP226 - Same Cut, Different Price: A Five Year Retrospective Review of Robotic and Laparoscopic Right Colectomies From a Single Surgeon Center

Purpose/Background: Robotics continues to be a highly utilized tool in an effort to improve patient outcomes. Prior research from our institution looked at right colectomy data during the transition period of laparoscopic to robotic surgery, noting no significant differences in oncologic or patient-related outcomes. We compiled additional data to look at a nearly five year span comparing outcomes again between robotic and laparoscopic surgery at our institution to see if any outcomes changed.

Methods/Interventions: In this retrospective chart review we identified all laparoscopic and robotic right colon resections performed since 2021 by our colorectal surgeon at our single institution. Patient demographics, oncologic outcomes, and perioperative outcomes were reviewed.

Results/Outcomes: 192 patients were identified. 79 patients underwent robotic right colectomies and 113 underwent laparoscopic right colectomies. Margin rate in all oncologic cases was negative. Length of stay was not significantly different between the two groups (3.75 vs 3.34, p=0.14). Morphine milliequivalent (MME) use postoperatively was also not statistically different (130 vs 121, p=0.67). Node harvest and stage of cancer at surgery were not different between the two groups either. Operative time was significantly longer for the robotic group compared to the laparoscopic group (182 minutes versus 138 minutes, p=0.0001). We then performed a subgroup analysis of robotic intracorporeal anastomoses (ICA) versus extracorporeal anastomoses (ECA). We found higher operative times with ICA cases (219 minutes versus 174 minutes, p=0.0115), but no significant difference in MME or length of stay.

Conclusion/Discussion: Our results suggest that despite adaptation of robotics into our regular practice, outcomes continue to be equivalent in outcomes to laparoscopic surgery for right colectomies. Similar to other studies, robotic right colectomies have longer operative times. Interestingly, other large retrospective studies suggest shorter hospital stays for robotic right colectomies versus laparoscopic (6.5 vs 10.2). However for both our cohorts length of stay average was less than 4 days on average and was not statistically significant. Other studies have also found lower opiate use after robotic right colectomies. While our study shows no difference, it is unclear if this is due to most cases from both cohorts undergoing extracorporeal anastomoses, which require larger incisions. Future studies will continue to compile data from new cases and assess if outcomes differ between junior and senior resident involvement.