Department of Surgery, Amphia Hospital, Molengracht 21, 4811GX, Breda, The Netherlands.
Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.
J Robot Surg. 2023 Oct;17(5):2315-2321. doi: 10.1007/s11701-023-01646-3. Epub 2023 Jun 21.
Robotics facilitates the realization of intra-corporeal anastomosis during right hemicolectomy and allows extracting the operative specimen through a C-section, offering potential benefits in terms of post-operative recovery and incidence of incisional hernia. Therefore, we progressively implemented robotic right hemicolectomy (robRHC) in our centre, and would like to report our initial experience with the technique. Consecutive patients who underwent robRHC within a single centre were prospectively included. Variables related to patients' demographics, surgical procedures, post-operative recovery and pathological outcomes were collected. Sixty patients underwent robRHC in our centre. Indications for robRHC were colon cancer in 58 patients (96.7%) and polyps not amenable to endoscopic resection in 2 patients (3.3%). Fifty-eight patients underwent robRHC with D2 lymphadenectomy and central vessel ligation (96.7%), and two patients (3.3%) had robRHC associated with another procedure. All patients had intra-corporeal anastomosis. The mean ± operative time was of 200.4 ± 114.9 min. Two conversions (3.3%) to open surgery were performed. The mean ± SD length of stay was of 5.4 ± 3.8 days. Seven patients (11.7%) experienced a post-operative complication with a Clavien-Dindo score ≥ 2. Two patients (3.5%) had an anastomotic leak. The mean ± SD number of harvested lymph nodes was of 22.4 ± 7.6. All patients had negative pathological margins (R0 resection). To conclude, robotic RHC is a safe procedure, which can be implemented with satisfying peri- and post-operative outcomes. The potential benefits of the technique remain to be demonstrated by randomized controlled trials.
机器人技术有助于实现右半结肠切除术的体内吻合，并允许通过 C 形切口取出手术标本，从而在术后恢复和切口疝发生率方面具有潜在益处。因此，我们在中心逐步实施了机器人右半结肠切除术（robRHC），并希望报告我们使用该技术的初步经验。在单一中心前瞻性纳入接受 robRHC 的连续患者。收集与患者人口统计学、手术程序、术后恢复和病理结果相关的变量。我们中心有 60 例患者接受了 robRHC。robRHC 的适应证为 58 例结肠癌（96.7%）和 2 例内镜切除不可行的息肉（3.3%）。58 例患者接受了 robRHC 联合 D2 淋巴结清扫和中央血管结扎（96.7%），2 例患者（3.3%）接受了 robRHC 联合其他手术。所有患者均进行了体内吻合。手术时间的平均值为 200.4±114.9 分钟。有 2 例（3.3%）转为开腹手术。平均住院时间为 5.4±3.8 天。7 例（11.7%）患者发生术后并发症，Clavien-Dindo 评分≥2 分。2 例（3.5%）患者发生吻合口漏。平均采集的淋巴结数为 22.4±7.6 个。所有患者均获得阴性病理切缘（R0 切除）。总之，机器人右半结肠切除术是一种安全的手术，可获得满意的围手术期和术后结果。该技术的潜在益处仍需通过随机对照试验来证明。
