Randomized clinical trial of robot-assisted versus standard laparoscopic right colectomy

Abstract

Background: Robotic surgery was invented to overcome the demerits of laparoscopic technique. However, it is unclear whether robot-assisted colectomy (RAC) has significant clinical advantages over laparoscopically assisted colectomy (LAC) in treating colonic cancer. The aim of this study was to compare the surgical outcomes of RAC versus LAC for right-sided colonic cancer. Methods: Patients with right-sided colonic cancer were randomized to receive RAC or LAC. The primary outcome measure was length of hospital stay. Secondary outcomes were duration of operation, morbidity, postoperative pain, hospital costs and pathological quality of the specimen. Results: Of 71 patients randomized, 70 (35 in each group) were included in the analysis. Hospital stay, surgical complications, postoperative pain score, resection margin clearance and number of lymph nodes harvested were similar in both groups. The duration of surgery was longer in the RAC group (195 versus 130 min; P < 0·001). No conversion to open surgery was needed in either group. Overall hospital costs were significantly higher for RAC (US $ 12 235 versus $ 10 320; P = 0·013); the higher costs were attributed primarily to the costs of surgery, including consumables. Conclusion: Robotic-assisted laparoscopic right colectomy was feasible but provided no benefit to justify the greater cost. Registration number: NCT01042743 (http://www.clinicaltrials.gov).