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Session:: ePosters-Sat-M6: Colon and Colorectal Cancer

EP165 - Intracorporeal versus Extracorporeal Anastomosis For Robotic Left Sided Colon Surgeries: A Comparative Study

Saturday, May 9, 2026
3:47 PM - 3:52 PM ET

    ePoster Presenter(s)

  • LC

    Lily Choi, DO

    Surgery Resident
    Englewood Health Medical Center
    North Bergen, New Jersey, United States

    Disclosure information not submitted.

    • Author(s)

  • DA

    David Ayob, MS1

    Medical Student
    Rutgers Medical School
    Newark, New Jersey, United States

    Disclosure information not submitted.

  • RG

    Richard J. Gonzalo, MD

    Resident physician
    Hackensack Meridian Health
    staten island, New York, United States

    Disclosure information not submitted.

  • AF

    Alexander Fortgang, DO

    Physician
    Englewood Health
    Englewood, New Jersey, United States

    Disclosure information not submitted.

  • PK

    Peter Kaye, MD

    Colorectal Surgeon
    Englewood Hospital and Medical Center
    Englewood, New Jersey, United States

    Disclosure information not submitted.

  • AS

    Anna Serur, MD

    Chief of Colon and Rectal Surgery
    Englewood Health Medical Center
    Englewood, New Jersey, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • MM

    Michael Marco, MD

    Colorectal Surgeon
    Englewood Health
    Englewood, New Jersey, United States

    Disclosure information not submitted.

Purpose/Background: Intracorporeal anastomosis (ICA) in right-sided colectomies has been shown to reduce surgical site infections (SSIs), incisional hernia rates, hospital length of stay, and overall postoperative complications compared to extracorporeal anastomosis (ECA). However, evidence comparing IC and EC techniques in left-sided colectomies remains limited. This study aims to evaluate and compare perioperative and postoperative outcomes between IC and EC anastomosis in left-sided robotic colon resections.

Methods/Interventions: This was a retrospective chart review for robotic cases done in a single center from year 2018 to 2025. The study included all robotic left sided colon procedures with primary anastomosis (Low anterior resection, sigmoidectomy, left hemicolectomy). Elective and emergency cases were included. In the ECA group, the bowel was externalized to perform the anastomosis. In the ICA group, resection and anastomosis were done intra-corporeal with no externalization. An independent t-test and Chi-square test were used for univariate analysis of numerical and categorical variables, respectively. A binary logistic regression test was used for multivariate analysis.

Results/Outcomes: A total of 716 patients were included in this study. ICA was performed in 445 patients (62%), while ECA was performed in 271 patients (38%). Table 1 presents the demographic and baseline characteristics of the study population. The mean operative time was significantly shorter in the ICA group compared to the ECA group (215 vs. 232 minutes, p = 0.03). Pfannenstiel incisions were used more frequently in the ICA group (85% vs. 51%, p < 0.001) compared to more midline mini-laparotomies in the ECA group. The ICA group also had a lower rate of conversion to open surgery (0.4% vs. 2.9%, p = 0.006).

Postoperatively, the average length of hospital stay was significantly shorter in the ICA group (2.67 vs. 3.83 days, p < 0.001). The incidence of incisional hernia was also significantly lower in the ICA group (1.3% vs. 4.4%, p = 0.01). There were no statistically significant differences between the two groups in terms of anastomotic leak rates, need for splenic flexure mobilization, surgical site infections, postoperative bleeding, or 30-day postoperative complications.

Conclusion/Discussion: In robotic left-sided colectomies, ICA is associated with enhanced perioperative and postoperative outcomes, including faster recovery and fewer wound-related complications, without an increased risk of anastomotic leak or other adverse events.

Demographics
Intracorporeal and Extracorporeal Anastomosis Patient Demographics