Does telerobotic assistance improve laparoscopic colorectal surgery?
OBJECTIVE
The laparoscopic approach is common for several surgical procedures. Although the laparoscopic approach in colorectal surgery is described as being beneficial, its use is not yet widespread. This restriction may be due to technical difficulties. The use of telerobotic assistance may simplify complex laparoscopic procedures. We compared the traditional laparoscopic and the telerobotic-assisted approaches to colorectal surgery.


METHODS
Between August 2002 and January 2004, 61 laparoscopic colorectal operations were performed. In this study we focused on sigmoid resection for benign disease. Twenty-three patients underwent sigmoid resection for diverticulitis using traditional laparoscopy, and 4 using telerobotic-assisted laparoscopy. The DaVinci system was used for telerobotic assistance. Four patients underwent resection rectopexies, 2 with traditional and 2 with telerobotic-assisted laparoscopy.


RESULTS
The DaVinci device worked well during all operations. No robot-related complications occurred. The conversion rate was 3 out of 23 with traditional laparoscopy and 1 out of 4 in the telerobotic-assisted group. The incidence of postoperative complications was 5 out of 23 after traditional laparoscopic and 1 out of 4 following telerobotic-assisted laparoscopic resection. Operation time was significantly longer using the telerobotic-assisted approach (236.7+/-5.8 vs. 172.4+/-38 min, p<0.05).


CONCLUSIONS
Colorectal surgery using the DaVinci system is safe and feasible. Compared to traditional laparoscopy, we did not see any relevant practical advantages of the supportive features of the telerobotic assistance that simplified the operation significantly. However, it would be useful to evaluate the telerobotic-assisted approach for other kinds of laparoscopic procedures.
Woeste
Guido
G
Department of General and Vascular Surgery, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. guido.woeste@kgu.de
Bechstein
W O
WO
Wullstein
C
C
D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000601:surgery; D003108:Colonic Diseases / Q000601:surgery*; D004867:Equipment Design; D004869:Equipment Safety; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome