84 - Freie Mitteilung
17. Mai 2019, 08:15 - 09:45, Bellavista 5, 6. OG
Robotic-assisted rectosigmoidectomy with the da Vinci Xi system – In comparison to the laparoscopic procedure
D. Daume, F. V. Angehrn, D. Steinemann, S. Drews, M. von Flüe, B. Kern, M. Bolli, Presenter: D. Daume (Basel)
Since June 2015 we perform robotic-assisted rectosigmoidectomies (RAR) with the da Vinci Xi. To evaluate the quality of this technique in our hands we analyzed perioperative results over a period of 36 months and compared them to patients who underwent laparoscopic rectosigmoidectomies (LAR) in the same period.
Retrospective analysis of prospectively collected data between June 2015 and May 2018. RAR was performed in 128 patients (67 female, 61 male) by 5 surgeons and LAR in 241 patients (138 female, 103 male) by 12 surgeons. Perioperative outcome was evaluated. Significance level for P-Value < 0.05.
The average age was 64.17 (±11.47) in the RAR and 64.00 (±12.38) in the LAR (p=n.s). Indications for RAR were in 113 patients diverticular disease, in 13 patients carcinoma and in 2 patients an adenoma. For LAR 173 diverticular diseases, 62 carcinomas, 1 volvulus and 1 adenoma lead to surgery. Mean operating time was 297min (±59.2) in the RAR group and 217min (±62.04) in the LAR group (p<0.001). 2 conversions to open surgery in the RAR, 12 conversions in the LAR (p=n.s.). Morbidity in RAR group was 24.2% (Clavien-Dindo III-IV 6.3%), in LAR group 21.2% (Clavien-Dindo III-IV 7.5%) (p=n.s.). There were 2 anastomotic leakages and a total of 7 reoperations after LAR, 1 anastomotic leakage including 1 reoperation occurred after RAR (p=n.s.). There was no mortality in both groups. Length of hospital stay was statistically not different (10.5 days (±4.38) after RAR and 10.85 days (±9.04) after LAR).
After implementation of the da Vinci Xi the analysis of our own results showed that the RAR is a safe approach and the outcome is at least equivalent to the LAR. There is a trend for a lower conversion and reoperation rate using the robotic assisted technique.