The impact of body mass index on outcomes in robotic colorectal surgery: a single-centre experience

Hannan, Enda; Troy, Amanda; Feeney, Gerard; Ullah, Mohammad Fahad; Ryan, Claire; McNamara, Emma; Coffey, J. Calvin; Peirce, Colin

doi:10.1007/s11701-021-01235-2

Cited by 5 publications

(16 citation statements)

References 32 publications

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“…The search strategy yielded 295 articles which were screened by title then abstract. Following this screening, 32 full-text articles were assessed for eligibility, with eight studies included in qualitative synthesis [19][20][21][22][23][24][25][26] and five studies ultimately included in metaanalysis [21][22][23][24][25] (Fig. 1).…”

Section: Study Selectionmentioning

confidence: 99%

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Robotic colon surgery in obese patients: a systematic review and meta‐analysis

Wang

Johnson

Casey

et al. 2022

ANZ Journal of Surgery

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Background: Colon cancer resection can be technically difficult in the obese (OB) population. Robotic surgery is a promising technique but its benefits remain uncertain in OB patients. The aim of this study is to compare OB versus non-obese (NOB) patients undergoing robotic colon surgery, as well as OB patients undergoing robotic versus open or laparoscopic colonic surgery. Methods: A systematic review and meta-analysis was performed. Primary outcome measures included length of stay (LOS), surgical site infection (SSI) rate, complications, anastomotic leak and oncological outcomes. Results: A total of eight studies were included, with five comparing OB and NOB patients undergoing robotic colon surgery included in meta-analysis. A total of 263 OB patients and 400 NOB patients formed the sample for meta-analysis. There was no significant difference between the two groups in operative time, conversion to open, LOS, lymph node yield, anastomotic leak and postoperative ileus. There was a trend towards a significant increase in overall complications and SSI in the OB group (32.3% OB versus 26.8% NOB for complications, 14.2% OB versus 9.9% NOB for SSI). The three included studies comparing surgical techniques were too heterogeneous to undergo meta-analysis. Conclusion: Robotic colon surgery is safe in obese patients, but high-quality prospective evidence is lacking. Future studies should report on oncological safety and the costeffectiveness of adopting the robotic technique in these challenging patients.

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Section: Study Selectionmentioning

confidence: 99%

“…Seven studies 19,[21][22][23][24][25][26] reported on operating time, with three studies 22,23,25 comparing OB and NOB patients included in pooled analysis. Two studies comparing OB and NOB patients were excluded from meta-analysis due to lack of required data.…”

Section: Operative Timementioning

confidence: 99%

Robotic colon surgery in obese patients: a systematic review and meta‐analysis

Wang

Johnson

Casey

et al. 2022

ANZ Journal of Surgery

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“…An elevated body mass index is associated with increased rates of surgical site infection, wound dehiscence, incisional hernia, pelvic abscess, anastomotic leak, and stoma-related complications. [18][19][20] Patients with obesity have a thicker mesentery and omentum which can restrict operative space in which to maneuver, distort surgical planes, and can lead to bleeding. 20 Given the rising incidence, colorectal surgeons are operating on more patients suffering with obesity and obese patients are more likely to face conversion to open surgery.…”

Section: The Challenging Mesentery-crohn's Disease and Elevated Body ...mentioning

confidence: 99%

“…[18][19][20] Patients with obesity have a thicker mesentery and omentum which can restrict operative space in which to maneuver, distort surgical planes, and can lead to bleeding. 20 Given the rising incidence, colorectal surgeons are operating on more patients suffering with obesity and obese patients are more likely to face conversion to open surgery. Recent work has suggested that the inherent benefits of minimally invasive surgery can be extended from laparoscopic to robotic.…”

Section: The Challenging Mesentery-crohn's Disease and Elevated Body ...mentioning

confidence: 99%

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Operating on the Mesentery in Robotic Colonic Surgery—General Techniques

Coulter

Peirce

2022

Clin Colon Rectal Surg

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During colorectal surgery the mesentery is the organ on which the greatest amount of operating time is focused. It has recently gained increasing attention. This technical review focuses on the mesentery during robotic colonic procedures. Specifically, we focus upon how to access, dissect, and divide the mesentery using the robotic platform. We also touch on the management of bleeding and some specific disease etiologies.

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