FTP3.6 Robotic Assisted Surgery – the future for patients with increased BMI?
Eleanor Massie, Rebecca Hughes, James Saldanha, Andrew Renwick, Mark Vella, Susan Moug- Surgery
Abstract
Introduction
Obesity increases the technical difficulty of laparoscopic colorectal surgery. The ROLAR trial concluded robotic assisted surgery (RAS) did not significantly reduce the risk of conversion to open surgery in rectal cancer resections. In Scotland, in 2021, 30% of adult population were obese (BMI ≥30kg/m2) and 4% morbidly obesity (BMI ≥40kg/m2.) We describe local experience of laparoscopic surgery and RAS in the obese population.
Methods
Retrospective review of patients with obesity (BMI ≥30kg/m2) undergoing laparoscopic and robotic colorectal surgery by three colorectal surgeons. Conversion to open, 30-day morbidity and mortality and length of stay were assessed.
Results
30 patients undergoing laparoscopic surgery and 37 patients undergoing RAS. Procedures include anterior resection; Hartmann’s procedure; left and right hemicolectomy, sigmoid colectomy, APER, subtotal colectomy, panproctocolectomy and completion proctectomy for benign and malignant conditions.
Conclusions
RAS resulted in fewer conversions to open procedures compared to laparoscopic surgery in the obese population. Fewer complications and returns to theatre in RAS group. The increased length of stay in RAS group can be explained by geographic considerations (25 RAS patients live >2 hours from hospital).