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Surg Endosc. 2014 Jan;28(1):212-21. doi: 10.1007/s00464-013-3163-5. Epub 2013 Aug 31.

Comparative effectiveness of laparoscopic versus robot-assisted colorectal resection.

Author information

1
Division of Colorectal Surgery, Department of Surgery, University Hospitals-Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106-5047, USA, debby_keller@hotmail.com.

Abstract

BACKGROUND:

During the past 20 years, laparoscopy has revolutionized colorectal surgery. With proven benefits in patient outcomes and healthcare utilization, laparoscopic colorectal surgery has steadily increased in use. Robotic surgery, a new addition to colorectal surgery, has been suggested to facilitate and overcome limitations of laparoscopic surgery. Our objective was to compare the outcomes of robot-assisted laparoscopic resection (RALR) to laparoscopic resections (LAP) in colorectal surgery.

METHODS:

A national inpatient database was evaluated for colorectal resections performed over a 30-month period. Cases were divided into traditional LAP and RALR resection groups. Cost of robot acquisition and servicing were not measured. Main outcome measures were hospital length of stay (LOS), operative time, complications, and costs between groups.

RESULTS:

A total of 17,265 LAP and 744 RARL procedures were identified. The RALR cases had significantly higher total cost ($5,272 increase, p < 0.001) and direct cost ($4,432 increase, p < 0.001), significantly longer operating time (39 min, p < 0.001), and were more likely to develop postoperative bleeding (odds ratio 1.6; p = 0.014) than traditional laparoscopic patients. LOS, complications, and discharge disposition were comparable. Similar findings were noted for both laparoscopic colonic and rectal surgery.

CONCLUSIONS:

RALR had significantly higher costs and operative time than traditional LAP without a measurable benefit.

PMID:
23996335
DOI:
10.1007/s00464-013-3163-5
[Indexed for MEDLINE]

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