title: Robotic versus laparoscopic resection for sigmoid diverticulitis with fistula.
abstract: Robotic abdominal surgery is growing despite a paucity of clinical reports to evaluate its impact on patient outcomes. In this retrospective case series, we aim to analyze our early experience with robotic resection in 11 consecutive patients with chronic colonic diverticulitis complicated by fistula to bladder, vagina, or skin and to compare the results of the robotic approach to 20 patients undergoing laparoscopic resection for the same indication. Our main outcome measures include operative time, blood loss, conversion rate, transfusion rate, hospital length of stay, complications, readmission, and fistula healing rate. In our study, we found robotic resection for colonic diverticulitis with fistula was technically feasible and yielded 100% fistula healing rate. The operative time, complication and readmission rates were similar to laparoscopy. A higher conversion rate, diverting stoma need, and longer hospital length of stay were noted in the robotic group; however, these findings could have been attributed to a higher number of cases involving rectal excision in the robotic group. Larger studies are needed to further examine the impact of robotic surgery on the outcome of patients with complicated chronic sigmoid diverticulitis.
authors.affiliation: Department of Urology, Kaiser Permanente LA Medical Center, Los Angeles, CA, USA. peter.a.elliott@kp.org.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Elliott
authors.affiliation: Department of Surgery, Kaiser Permanente LA Medical Center, Los Angeles, CA, USA. Elisabeth.C.McLemore@kp.org.
authors.forename: Elisabeth C
authors.initials: EC
authors.lastname: McLemore
authors.affiliation: Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA. abbassmohd@gmail.com.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Abbass
authors.affiliation: Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA. AbbasM@clevelandclinicabudhabi.ae.|Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Al-Maqam Tower, Sowwah Sq., Al-Maryah Island, PO Box 112412, Abu Dhabi, UAE. AbbasM@clevelandclinicabudhabi.ae.
authors.forename: Maher A
authors.initials: MA
authors.lastname: Abbas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D012809:Colon, Sigmoid / Q000601:surgery*; D004238:Diverticulitis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: Colocutaneous fistula; Colovaginal fistula; Colovesical fistula; Diverticulitis; Laparoscopic surgery; Robotic surgery