Robot-Assisted vs Laparoscopic Right Hemicolectomy in Octogenarians

Robotic colorectal cancer surgery in the elderly – a monocentric analysis of short- term postoperative outcomes in patients ≥ 75 years versus <75 years

“…With the increased use of robotic platforms, robotic outcomes in the elderly are also increasingly monitored, and in general, robotic procedures seem to be well tolerated by the elderly population (14,15,16). In robotic colorectal surgery, one could assume that due to longer operating times and (in platforms without table motion), longer static Trendelenburg positioning, postoperative robotic outcomes in the elderly might be poor, however, evidence so far suggests that robotic surgery is well-tolerated by the elderly population with comparable postoperative morbidity, lower conversion rates and shorter lengths of stay in the robotic groups (7,17,18).…”

“…Laparoscopic colorectal surgery has been well established as the surgical standard of care over the last decades. Despite initial concerns about the tolerance of lengthy procedures in Trendelenburg position with pneumoperitoneum and consequently raised abdominal pressure in the older age group, several authors have assessed and con rmed the safety of laparoscopic colorectal surgery in elderly and "superelderly" (> 85 years) patients (4,5,6,7,8,9). Robotic colorectal surgery is rapidly emerging worldwide and is a promising tool in the future of minimalinvasive surgery.…”

“…De'Angelis et al compared 43 patients in a laparoscopic colorectal resection group to 43 patients in a robotic colorectal resection group, all over 70 years, and found similar operative and oncological outcomes, with longer operative time in the robotic group (17). Srinath et al compared laparoscopic and robotic right hemicolectomies in octogenarians (patients > 80 years) and observed a shorter length of stay in the robotic group, with similar oncological outcomes as well as similar complication rates (7). Palomba et al found similar outcomes in their study comparing 32 robotic vs. 51 laparoscopic colonic resections in patients > 65 years.…”