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Robotic colorectal resection in combination with a multimodal enhanced recovery program - results of the first 100 cases

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A Correction to this article was published on 26 March 2024

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Abstract

Purpose

In Germany, colorectal robot-assisted surgery (RAS) has found its way and is currently used as primary technique in colorectal resections at our clinic. We investigated whether RAS can be extensively combined with enhanced recovery after surgery (ERAS®) in a large prospective patient group.

Methods

Using the DaVinci Xi surgical robot, all colorectal RAS from 09/2020 to 01/2022 were incorporated into our ERAS® program. Perioperative data were prospectively recorded using a data documentation system. The extent of resection, duration of the operation, intraoperative blood loss, conversion rate, and postoperative short-term results were analyzed. We documented the postoperative duration of Intermediate Care Unit (IMC) stay and major and minor complications according to the Clavien–Dindo classification, anastomotic leak rate, reoperation rate, hospital-stay length, and ERAS® guideline adherence.

Results

One hundred patients (65 colon and 35 rectal resections) were included (median age: 69 years). The median durations of surgery were 167 min (colon resection) and 246 min (rectal resection). Postoperatively, four patients were IMC-treated (median stay: 1 day). In 92.5% of the colon and 88.6% of the rectum resections, no or minor complications occurred postoperatively. The anastomotic leak rate was 3.1% in colon and 5.7% in rectal resection. The reoperation rate was 7.7% (colon resection) and 11.4% (rectal resection). The hospital stay length was 5 days (colon resection) and 6.5 days (rectal resection). The ERAS® guideline adherence rate was 88% (colon resection) and 82.6% (rectal resection).

Conclusion

Patient perioperative therapy per the multimodal ERAS® concept is possible without any problems in colorectal RAS, leading to low morbidity and short hospital stays.

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Authors and Affiliations

  1. Department of general and visceral surgery, Helios Kliniken Schwerin, Wismarsche Straße 393 – 397, 19055, Schwerin, Germany

    M. El-Ahmar, F. Peters, M. Green, M. Dietrich, M. Ristig & J.-P. Ritz

  2. Department of Anesthesiology, Helios Kliniken Schwerin, Wismarsche Straße 393 – 397, 19055, Schwerin, Germany

    L. Moikow

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  1. M. El-Ahmar
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  3. M. Green
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Contributions

All the authors contributed to the conception and design of the study. Material preparation, data collection and analysis were performed by Mohamad El-Ahmar, Melanie Dietrich, Martina Green, Lutz Moikow and Franziska Koch. Matthias Ristig and Jörg-Peter Ritz set the target parameters and monitored the analysis. Mohamad El-Ahmar wrote the manuscript. Jörg-Peter Ritz commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to M. El-Ahmar.

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All authors have provided consent for publication.

Informed consent

Patients’ informed consent to participate in the study has been obtained.

Research involving human participants

Ethical approval was waived by the local Ethics Committee of the medical faculty of the University of Rostock on January 10, 2019, in view of the prospective nature of the study and all procedures having been performed as part of routine care.

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There are no relevant financial or non-financial competing interests to report.

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El-Ahmar, M., Peters, F., Green, M. et al. Robotic colorectal resection in combination with a multimodal enhanced recovery program - results of the first 100 cases. Int J Colorectal Dis 38, 95 (2023). https://doi.org/10.1007/s00384-023-04380-2

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