Totally laparoscopic and totally robotic surgery in patients with left‐sided colonic diverticulitis

Abstract

Background: Introduction of the da Vinci Xi system has facilitated the use of robotics in colorectal surgery. Nevertheless, data on the outcomes of robotic surgery for the treatment of colonic diverticulitis have remained scarce. Methods: Patient demographics, clinical characteristics, and perioperative outcomes of the patients undergoing totally robotic with the da Vinci Xi system or laparoscopic surgery for left-sided colonic diverticulitis (LCD) were compared. Results: Laparoscopic and robotic groups included 22 and 20 patients, respectively. There were no significant differences between the two groups in terms of patient demographics, clinical characteristics, operative time, and postoperative complications. There were three conversions in the laparoscopy group and no conversion in the robotic group (P = 0.23). Conversion to open surgery was associated with postoperative morbidity (P = 0.02). Conclusion: Robotic surgery is an applicable alternative for the treatment of LCD. Robotic approach may potentially lower the risk of operative morbidity by reducing the requirement of conversion. K E Y W O R D S colectomy, laparoscopic surgery, left sided colonic diverticulitis, robotic surgery

Robotic versus laparoscopic colorectal surgery in elderly patients in terms of recovery time: a monocentric experience

“…In this recent study, Keller et al showed that laparoscopic surgery for colorectal cancer in the elderly, in addition to the clinical benefits, reduces overall costs in comparison to open surgery [ 15 ]. Robotic surgery was born to overcome the limits of laparoscopy (2-D vision, reduced ergonomics in confined spaces, tremor effect and unnatural hand–eye coordination) and was successfully applied to urology, general and pediatric surgery, gynaecology, and other surgical fields [ 11 , 12 , 17 , 28 , 29 ]. Robotic surgery has some advantages, such as shorter learning curve, 3-D views, increased wrist flexibility, better ergonomic benefits, reduction of hand tremor and surgeon workloads [ 8 , 11 , 12 , 16 , 17 , 30 ].…”

“…Robotic surgery was born to overcome the limits of laparoscopy (2-D vision, reduced ergonomics in confined spaces, tremor effect and unnatural hand–eye coordination) and was successfully applied to urology, general and pediatric surgery, gynaecology, and other surgical fields [ 11 , 12 , 17 , 28 , 29 ]. Robotic surgery has some advantages, such as shorter learning curve, 3-D views, increased wrist flexibility, better ergonomic benefits, reduction of hand tremor and surgeon workloads [ 8 , 11 , 12 , 16 , 17 , 30 ]. Comparison between robotic and laparoscopic surgery is considered a “hot topic”.…”

“…However, laparoscopy has some intrinsic limitations such as two-dimensional (2D) visualization, reduced ergonomics in confined spaces, tremor effect and possible incoordination between the surgeon’s eye and hand. [ 11 , 12 ]. Laparoscopy is safe and feasible for colorectal cancer surgery in the elderly and beyond these benefits described, also has improved short-term postoperative outcome more in elderly than in younger patients [ 13 – 15 ].…”

“…The robotic technique was developed as the evolution of conventional laparoscopy [ 1 , 7 , 11 ]. Robotic surgery provides several advantages such as three-dimensional (3D) high-definition vision, greater freedom and control on operating instruments, flexible wrists, and filtration of hand tremor to improve maneuverability and operative comfort [ 8 , 11 , 12 , 16 , 17 ]. The robotic technique for colorectal surgery was introduced in 2002 by Weber [ 18 ].…”

Robotic-Assisted Laparoscopic Resection of Tailgut Cysts

“…Further advantages are a tremor and motion filtration, the endowrist function with superior maneuverability of the instrument, three-dimensional binocular vision imaging, and motion scaling. 3 , 4 This explains why resections of para and retro-rectal tumors such as tailgut cysts are particularly suitable operations for robotic surgery.…”