title: Totally robotic vs 3D laparoscopic colectomy: A single centers preliminary experience.
abstract: OBJECTIVE
  To compare robotic and three-dimensional (3D) laparoscopic colectomy based on the literature and our preliminary experience.
  
  
  METHODS
  This retrospective observational study compared operative measures and postoperative outcomes between laparoscopic 3D and robotic colectomy for cancer. From September 2013 to September 2014, 24 robotic colectomies and 23 3D laparoscopic colectomy were performed at our Department. Data were analyzed and reported both by approach and by colectomy side. Robotic left colectomy (RL) vs laparoscopic 3D left colectomy (LL 3D) and Robotic right colectomy (RR) vs laparoscopic 3D (LR 3D). Rectal cancer procedures were not included.
  
  
  RESULTS
  There were 18 RR and 11 LR 3D, 6 RL and 12 LL 3D. As regards LR 3D, extracorporeal anastomosis (EA) was performed in 7 patients and intracorporeal anastomosis (IA) in 4; the RR group included 14 IA and 4 EA. There was no mortality. Median operative time was higher for the robotic group while conversion rate (12.5% vs 13%) and lymph nodes removed (14 vs 13) were similar for both. First flatus time was 1 d for RR and 2 d the other patient groups. Oral intake was resumed in 1 d by LR and in 2 d by the other patients (P = 0.012). Overall cost was €4950 and €1950 for RL and LL 3D, and €4450 and €1450 for RR and LR 3D, respectively.
  
  
  CONCLUSIONS
  There were no differences between RR and LR 3D, except that IA was easier with RR, and probably contributed with the learning curve to the longer operative time recorded. Both techniques offer similar advantages for the patient with significantly different costs. In left colectomies robotic colectomy provided better outcomes, especially in resections approaching the rectum.
authors.affiliation: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Guerrieri
authors.affiliation: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Campagnacci
authors.affiliation: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Sperti
authors.affiliation: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Belfiori
authors.affiliation: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Gesuita
authors.affiliation: Mario Guerrieri, Roberto Campagnacci, Pierluigi Sperti, Giulio Belfiori, Roberto Ghiselli, Department of General Surgery, Clinica Chirurgica, Ospedali Riuniti, Polytechnic University of Marche, 60121 Ancona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ghiselli
mesh_terms: D000368:Aged; D002983:Clinical Competence; D003082:Colectomy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D003110:Colonic Neoplasms / Q000191:economics / Q000473:pathology / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics; D059032:Learning Curve; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D020127:Recovery of Function; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome
keywords: Colectomy; Costs; Laparoscopic surgery; Robotic surgery; Short-term outcomes; Three-dimensional vision systems