Our Summary

This study compared the outcomes of two different types of minimally invasive surgery for rectal conditions: laparoscopic proctectomy (a procedure performed using a small camera and instruments inserted through small incisions) and robotic proctectomy (a similar procedure, but controlled by a surgeon using a robotic system). Data was collected from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) for surgeries performed in 2016 and 2017.

The study found that 70% of the 3,845 patients studied had laparoscopic surgery, while 30% had robotic surgery. Those who had robotic surgery tended to be older and had a higher risk of complications, possibly due to having had previous treatments like chemotherapy or radiation.

The researchers found that patients who underwent robotic surgery were less likely to need conversion to open surgery (a traditional, more invasive procedure), had a shorter hospital stay, and had lower rates of a condition called postoperative ileus, which is a temporary stoppage of bowel movements. However, the robotic procedures took slightly longer to perform.

Despite these advantages, the researchers note that more research is needed to determine if the improved clinical outcomes from robotic surgery outweigh the potentially higher costs of using this technology.

FAQs

  1. What is the difference between laparoscopic proctectomy and robotic proctectomy?
  2. What were the key findings in the comparison of outcomes between laparoscopic and robotic proctectomies?
  3. Does the use of robotic surgery in proctectomies lead to higher costs despite improved clinical outcomes?

Doctor’s Tip

A helpful tip a doctor might tell a patient about proctectomy is to discuss with your surgeon the different types of minimally invasive surgery options available, such as laparoscopic and robotic proctectomy. Each option has its own benefits and potential risks, so it’s important to weigh them carefully and choose the best option for your individual situation. Additionally, make sure to ask your surgeon about their experience with the specific type of surgery you are considering, as this can also impact outcomes.

Suitable For

Patients who are typically recommended for proctectomy include those with conditions such as colorectal cancer, inflammatory bowel disease, rectal prolapse, and rectal tumors. Patients who have not responded to other treatments such as medications or radiation therapy may also be recommended for proctectomy. Additionally, patients who have a high risk of complications or who have had previous abdominal surgeries may be candidates for minimally invasive surgery options like laparoscopic or robotic proctectomy.

Timeline

Before proctectomy:

  • Patient undergoes preoperative evaluation and testing to determine the necessity and feasibility of the surgery
  • Patient may undergo bowel preparation to clean out the colon before surgery
  • Patient discusses the procedure with their surgeon and prepares for the surgery mentally and physically

After proctectomy:

  • Patient is monitored closely in the hospital for any postoperative complications
  • Patient receives pain management and support from the medical team
  • Patient begins the recovery process, which may involve physical therapy, dietary changes, and wound care
  • Patient follows up with their surgeon for postoperative care and monitoring
  • Patient gradually resumes normal activities and adjusts to any changes in bowel function or lifestyle due to the surgery

What to Ask Your Doctor

  1. What type of proctectomy procedure do you recommend for my specific condition?
  2. What are the potential risks and complications associated with both laparoscopic and robotic proctectomy?
  3. Are there any specific factors in my medical history that may impact the success of either type of surgery?
  4. How long is the recovery time for each type of procedure?
  5. Will I need any additional treatments or therapies after the proctectomy?
  6. What are the differences in cost between laparoscopic and robotic proctectomy, and will my insurance cover either procedure?
  7. How experienced are you in performing robotic proctectomy procedures?
  8. What are the potential long-term outcomes or side effects of the surgery?
  9. Are there any lifestyle changes or modifications I should consider after the surgery?
  10. Are there any alternative treatment options to consider before deciding on a proctectomy?

Reference

Authors: Hu KY, Wu R, Szabo A, Ridolfi TJ, Ludwig KA, Peterson CY. Journal: J Surg Res. 2020 Nov;255:495-501. doi: 10.1016/j.jss.2020.05.094. Epub 2020 Jul 1. PMID: 32622164