SP 11.16 Robotic versus Laparoscopic Colorectal Cancer Surgery at a UK Tertiary Centre: A Comparative Outcomes Analysis
Mohammed Arifuzaman, Madan Jha, Vikram GarudAbstract
Background
Minimally-invasive techniques dominate contemporary colorectal-cancer (CRC) surgery. Robotic platforms offer ergonomic and visual advantages, but their impact on operative efficiency and postoperative outcomes remains debated. This study compares robotic and laparoscopic CRC resections performed at James-Cook-University-Hospital.
Methods
A retrospective analysis was conducted on all oncologic colorectal resections recorded in the institutional theatre database. Procedure selection was based on operative descriptors (hemicolectomy, anterior resection, APER, sigmoid/left colectomy) while excluding benign indications. Final cohorts included 164 robotic and 80 laparoscopic resections. Outcomes analysed included operative duration, theatre time, length of stay (LOS), complications, and readmissions. Non-parametric testing and logistic/linear models adjusted for age, BMI, ASA grade, CCI, and procedure-type were applied.
Results
Unadjusted analysis showed longer robotic operating times (median 180 vs 154 min, p<0.01) and longer theatre duration (213.5 vs 190 min, p<0.01). LOS was comparable (median 4 vs 4 days, p=0.54). Complication rates were 29.9% robotic vs 20.0% laparoscopic (OR 1.68, 95% CI 0.89–3.16), while readmissions were similar (11.6% vs 12.5%). Adjusted models demonstrated no significant differences in complications or readmissions. A trend toward shorter LOS with robotics (–24%, p=0.09) did not meet significance. Procedure-specific analysis showed laparoscopic-right-hemicolectomy maintained significantly shorter operative times (p=0.026).
Conclusions
Robotic CRC-surgery is safe and achieves similar postoperative outcomes to laparoscopy but incurs longer operative times. Based on current data, laparoscopy should remain first-line for standard CRC resections, while robotics may be reserved for complex pelvic cases requiring enhanced dexterity. Further prospective evaluation, including cost analysis, is recommended.