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Erschienen in:
01.01.2011
Robotic-assisted laparoscopic surgery for recurrent diverticulitis: experience in consecutive cases and a review of the literature
Erschienen in: Surgical Endoscopy | Ausgabe 1/2011
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Background
Robotic-assisted laparoscopic surgery has recently gained enthusiasm for application in colorectal surgery. We present the safety and feasibility of using the da Vinci® robotic system for the surgical treatment of sigmoid diverticulitis.
Methods
Between August 2008 and November 2009, robotic-assisted laparoscopic anterior rectosigmoid resection (RALS-AR) for diverticulitis was performed in 24 consecutive patients. Demographic data, intraoperative parameters, and postoperative outcomes were assessed.
Results
RALS-AR was performed in 14 male (58.3%) and 10 female (41.7%) patients with a diagnosis of recurrent diverticulitis. The mean patient age and BMI were 49.8 ± 9.3 years (range = 30–62 years) and 29.9 ± 6.3 kg/m2 (range = 15.9–46.9 kg/m2), respectively. Disease stratification identified 15 cases of uncomplicated (62.5%) and 9 cases of complicated (37.5%) disease. The procedures required 14.1 ± 6.7 min (range = 6–30 min) for robotic docking, 100.5 ± 31.0 min (range = 50–180 min) for surgeon console time, and 224.2 ± 47.1 min (range = 150–330 min) for the total operative time. Robotic docking and surgeon console time represented 51.9% of the total operative time. A primary colorectal anastomosis was fashioned with avoidance of colostomy in all patients. There were no significant intraoperative complications, and none of the procedures required conversion to open, hand-assisted, or conventional laparoscopic technique. The length of hospital stay was 3.4 ± 2.6 days (range = 2–14 days), and the postoperative complication rate was 12.5% (n = 3). There were no anastomotic leaks, secondary surgical interventions, or hospital readmissions.
Conclusions
Robotic-assisted laparoscopic technique is a safe and feasible option for the surgical treatment of diverticulitis. The approach may be offered to patients with uncomplicated or complicated disease, and it results in a short hospital stay and low complication rate.