title: Robotic vs. laparoscopic colorectal surgery: an institutional experience.
abstract: BACKGROUND
  Robotic colorectal surgery is gaining interest in general and colorectal surgery. The use of the da Vinci(®) Robotic system has been postulated to improve outcomes, primarily by increasing the dexterity and facility with which complex dissections can be performed. We report a large, single institution, comparative study of laparoscopic and robotic colectomies, attempting to better elucidate the benefits of robotic surgery in patients with colorectal disease.
  
  
  METHODS
  We conducted a retrospective review of 171 patients who underwent robotic and laparoscopic colectomies (79 and 92, respectively) at our institution between November 2004 and November 2009. Patients in both groups had well-matched preoperative parameters. All cases were further subdivided by their anatomical location into right-sided and left-sided colectomy, and analysis was performed within these two subgroups. Perioperative outcomes reported include operative time, operative blood loss, time to return of bowel function, time to discontinuation of patient controlled analgesia, length of stay, and intraoperative or postoperative complications.
  
  
  RESULTS
  Our results indicate that there is no statistical difference in length of stay, time to return of bowel function, and time to discontinuation of patient-controlled analgesia between robotic and laparoscopic left and right colectomies. Interestingly, the total procedure time difference between the laparoscopic and robotic colectomies was much smaller than previously published accounts (mean 140 min vs. 135 min for right colectomy; mean 168 min vs. 203 min for left colectomy).
  
  
  CONCLUSIONS
  Our study is one of the largest reviews of robotic colorectal surgery to date. We believe that our results further demonstrate the equivalence of robotic surgery to laparoscopic surgery in colorectal procedures. Future research should focus on surgeon-specific variables, such as comfort, ergonomics, distractibility, and ease of use, as other ways to potentially distinguish robotic from laparoscopic colorectal surgery.
authors: Department of Surgery, North Shore University Hospital, North Shore-Long Island Jewish Health System, 300 Community Drive, Manhasset, NY 11030, USA.
authors: Gary B
authors: GB
authors: Deutsch
authors: Sandeep Anantha
authors: SA
authors: Sathyanarayana
authors: Vikraman
authors: V
authors: Gunabushanam
authors: Nitin
authors: N
authors: Mishra
authors: Eugene
authors: E
authors: Rubach
authors: Harry
authors: H
authors: Zemon
authors: Jonathan D S
authors: JD
authors: Klein
authors: George
authors: G
authors: Denoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003082:Colectomy / Q000379:methods*; D012809:Colon, Sigmoid / Q000601:surgery; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome