Our Summary

This research paper compares two types of surgery techniques - laparoscopic (a minimally invasive surgery that uses a tiny camera and several thin instruments) and robotic-assisted (where surgeons use a computer to control robotic arms). The study focuses on two specific types of surgeries, appendectomies (removal of the appendix) and cholecystectomies (removal of the gallbladder).

Over a span of two years, two skilled surgeons performed both techniques to compare various factors like the length of the operation, time taken for patients to be discharged, the need to switch to a traditional open surgery, and the need for patients to be readmitted within 30 days after the procedure.

The study found that the time taken for the operation was almost the same for both techniques. However, patients who underwent robotic-assisted surgeries were discharged faster. Also, only the laparoscopic procedures had to be changed to traditional open surgery in some cases, while none of the robotic-assisted surgeries needed such conversion. There were no readmissions in the appendectomy group and only three in the cholecystectomy group.

In conclusion, robotic-assisted surgeries did not take longer than the laparoscopic approach and even had some advantages like faster patient discharge and less chance of needing to switch to open surgery.

FAQs

  1. Does the robotic-assisted approach for appendectomies and cholecystectomies increase intraoperative time compared to the laparoscopic approach?
  2. Does the robotic-assisted approach decrease the time to discharge compared to the laparoscopic approach in appendectomies and cholecystectomies?
  3. Is there a lesser likelihood of conversion to open procedure in robotic-assisted appendectomies and cholecystectomies compared to the laparoscopic approach?

Doctor’s Tip

A doctor may tell a patient that robotic-assisted appendectomy has shown promising results in reducing the time to discharge and the likelihood for conversion to an open procedure compared to the traditional laparoscopic approach. It is important to discuss this option with your surgeon to determine the best approach for your specific case.

Suitable For

Patients who are typically recommended for an appendectomy are those who are experiencing symptoms of appendicitis, such as abdominal pain, fever, nausea, and vomiting. These patients may also have elevated white blood cell counts and imaging studies showing inflammation of the appendix.

Patients who are typically recommended for a cholecystectomy are those who have symptomatic gallstones, such as right upper quadrant abdominal pain, nausea, vomiting, and bloating. These patients may also have abnormal liver function tests and imaging studies showing gallstones in the gallbladder.

In the study mentioned in the abstract, both laparoscopic and robotic-assisted approaches were evaluated for appendectomy and cholecystectomy. The results showed that the robotic-assisted approach did not significantly increase intraoperative time compared to the laparoscopic approach, but did shorten the time to discharge and decrease the likelihood of conversion to an open procedure. This suggests that patients who may benefit from a quicker recovery and reduced risk of conversion to open surgery may be good candidates for a robotic-assisted approach to these procedures.

Timeline

  • Before appendectomy: The patient typically experiences symptoms such as abdominal pain, nausea, and vomiting, which may lead to a visit to the doctor or emergency room. After a physical examination and possibly imaging tests, a diagnosis of appendicitis is made, and surgery is recommended.

  • Day of appendectomy: The patient undergoes surgery, either laparoscopic or robotic-assisted, to remove the inflamed appendix. The procedure typically lasts around 1-2 hours.

  • After appendectomy: The patient is monitored in the recovery room for a few hours before being transferred to a hospital room. Pain medication is provided as needed, and the patient is encouraged to start walking and resume a normal diet gradually. The patient may stay in the hospital for 1-2 days before being discharged.

  • Follow-up: The patient is advised to follow up with their surgeon for a post-operative appointment to ensure proper healing and to discuss any concerns. Most patients can resume normal activities within 1-2 weeks after surgery.

Overall, appendectomy is a common and relatively straightforward surgical procedure with a quick recovery time, especially with the use of minimally invasive techniques such as laparoscopic or robotic-assisted surgery.

What to Ask Your Doctor

  1. What are the potential risks and benefits of undergoing a robotic-assisted appendectomy compared to a laparoscopic appendectomy?
  2. How does the cost of a robotic-assisted appendectomy compare to a laparoscopic appendectomy, and is it covered by insurance?
  3. What is the expected recovery time after a robotic-assisted appendectomy compared to a laparoscopic appendectomy?
  4. How likely is it that a robotic-assisted appendectomy will need to be converted to an open procedure during surgery?
  5. What is the likelihood of readmission within 30 days after a robotic-assisted appendectomy compared to a laparoscopic appendectomy?
  6. Are there any specific criteria that would make a patient a better candidate for a robotic-assisted appendectomy over a laparoscopic appendectomy?
  7. How experienced is the surgeon in performing robotic-assisted appendectomies, and what is their success rate with this procedure?
  8. What follow-up care is required after a robotic-assisted appendectomy, and how often will I need to see the surgeon for check-ups?
  9. Are there any long-term implications or considerations to keep in mind after undergoing a robotic-assisted appendectomy?

Reference

Authors: Rifai AO, Rembetski EM, Stutts LC, Mazurek ZD, Yeh JL, Rifai K, Bear RA, Maquiera AJ, Rydell DJ. Journal: J Robot Surg. 2023 Oct;17(5):2187-2193. doi: 10.1007/s11701-023-01632-9. Epub 2023 Jun 4. PMID: 37271758