Matched Comparative Study of Early Postoperative Outcomes between Laparoscopic Surgery and Robotic-Assisted Laparoscopic Surgery

Abstract

Minimally-invasive surgery is widely used in the treatment of colorectal diseases, despite its technical limitations. Robotic surgery emerges as an alternative, offering greater precision and optimized three-dimensional (3D) visualization, expanding the possibilities in colorectal procedures.

To evaluate the safety of the robotic platform and compare postoperative outcomes, such as length of hospital stay, complications, reoperations, and mortality, in comparison to laparoscopy.

A retrospective cohort study including 701 patients who underwent elective colorectal surgery at a tertiary hospital in Belo Horizonte (2022–2024). Clinical and surgical variables were analyzed using analysis of variance (ANOVA).

The sample included neoplasms (50.8%) and endometriosis (38.7%), with a predominance of laparoscopy (81.5%) compared with robotic surgery (18.5%). Both techniques demonstrated equivalent efficacy, with an overall conversion rate of only 1.4%. Most discharges occurred between the 3rd and 4th postoperative days, with length of stay significantly influenced by the diagnosis (oncology > endometriosis; p < 0.001), regardless of the surgical approach. Intraoperative complications occurred in 2% of cases, the reoperation rate was 3.9%, and overall mortality was 1%.

The technological transition proved to be successful. Low conversion rates and stable outcomes confirm robotics as a protective and facilitating factor in confined dissections, ensuring safety even during the learning curve.

The robotic platform is a safe and well-established alternative, offering perioperative outcomes equivalent to laparoscopy. Recovery is primarily determined by the underlying pathology, but robotic precision contributes to the effectiveness and modernization of colorectal disease treatment.