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Presentation Description
Institution: Royal Brisbane Women's Hospital - Queensland, Australia
Purpose:
Patient outcomes comparing robotic and laparoscopic colonic surgery to date are mostly generated from expert robotic surgeons beyond their initial learning curve. With the rapid advent of robotic colorectal surgery in public teaching hospitals, the comparison of patient outcomes of those undergoing robotic and laparoscopic right hemicolectomies in teaching hospitals by robot naïve fellows is limited. Surgical outcomes from a large quaternary teaching hospital where fellows were within the first 0-20 cases of their robotic training are presented.
Methodology:
Medical records of all robotic and laparoscopic right hemicolectomies performed at Royal Brisbane and Women’s Hospital since 2018 were reviewed. Primary outcomes were length of stay and operation time. Secondary outcomes were overall and cancer specific survival and complications.
Results:
26 robotic and 103 laparoscopic right hemicolectomies were performed. Baseline demographics (age, sex, ASA) were similar between robotic and laparoscopic groups apart from body mass index (32.5 robot, 26.7 laparoscopic, p=0.03). The robotic cohort demonstrated a statistically significant lower length of stay (3.6 vs 4.7 days, p=0.009) but an increased in both anaesthesia and operating time (p=0.008). There were no statistically significant differences in survival to 5 years, nodal harvest, R0 resection rate, complication rate (ileus, anastomotic leak, infection, bleeding), readmissions, and conversion to open.
Conclusion:
Robotic right hemicolectomy provides an equivalent if not improved outcomes for patients compared to laparoscopic right hemicolectomies in the hands of robot naïve fellows operating under supervision. A robotic right hemicolectomy is a safe and feasible training operation.
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Dr Jeffrey Lau - , Dr Amy Cao - , Dr Carina Chow -