Our Summary

This study looked at how effective and safe two types of surgery are for children who need to have part or all of their colon removed. The two methods compared were laparoscopic colectomy, which is a minimally invasive surgery using a small camera and tools, and robotic-assisted colectomy, where a surgeon uses a robot to help with the operation.

The researchers reviewed the medical records of children who had these surgeries between 2010 and 2023 at their hospital. They looked at various factors, including the children’s age and health conditions, what type of surgery they had, how long the surgery took, any complications that happened after the surgery, and how long the children stayed in the hospital.

In total, 55 surgeries were performed, with 31 being laparoscopic and 24 being robotic-assisted. The most common reason for surgery was inflammatory bowel disease. The surgeries took longer when done with the robotic-assisted method, averaging an extra 36 minutes.

There was no difference in the rate of complications after surgery between the two methods. In both cases, about a third of the children had complications, and similar percentages required additional treatment under general anesthesia. The children who had robotic-assisted surgery had slightly shorter hospital stays, but this difference was not significant.

However, the robotic-assisted surgeries were more expensive, costing an extra 2156€ ($2,500) per surgery on average.

In conclusion, the robotic-assisted surgery is as safe and effective as the laparoscopic method for children needing this type of surgery, but it takes longer and costs more.

FAQs

  1. What were the two types of surgery methods compared in this study?
  2. What were the main findings of the study regarding the effectiveness, safety, and cost of laparoscopic and robotic-assisted colectomy?
  3. Was there a significant difference in the length of hospital stays between children who had laparoscopic surgery and those who had robotic-assisted surgery?

Doctor’s Tip

A doctor might tell a patient considering colectomy that both laparoscopic and robotic-assisted surgeries are safe and effective options. However, the robotic-assisted surgery may take longer and be more expensive. It is important to discuss the pros and cons of each method with your healthcare provider to determine the best approach for your individual situation.

Suitable For

Patients who may be recommended for colectomy include those with severe inflammatory bowel disease, colorectal cancer, familial adenomatous polyposis, ulcerative colitis, Crohn’s disease, and other conditions that affect the colon. Additionally, patients who have complications from these conditions such as severe bleeding, perforation, or obstruction may also be candidates for colectomy. The decision to recommend colectomy will depend on the specific condition and individual circumstances of each patient.

Timeline

Before colectomy:

  1. Patient experiences symptoms such as abdominal pain, bloating, diarrhea, or rectal bleeding.
  2. Patient undergoes various tests such as colonoscopy, CT scans, and blood tests to diagnose the underlying condition.
  3. Patient and healthcare team discuss treatment options, including the possibility of colectomy.
  4. Patient undergoes preoperative preparation, which may include bowel cleansing and dietary restrictions.

After colectomy:

  1. Patient undergoes surgery, either laparoscopic or robotic-assisted, to remove part or all of the colon.
  2. Patient is monitored in the hospital for complications, such as infection or bleeding.
  3. Patient gradually resumes eating and drinking, starting with clear liquids and progressing to solid foods.
  4. Patient may experience changes in bowel habits and may need to adjust their diet and lifestyle.
  5. Patient is discharged from the hospital and continues to follow up with their healthcare team for monitoring and recovery.
  6. Patient may undergo rehabilitation or physical therapy to regain strength and function.
  7. Patient may experience long-term changes in bowel function and may require ongoing medical management.

What to Ask Your Doctor

  1. What are the reasons for recommending a colectomy for me or my child?
  2. What are the potential risks and complications associated with colectomy surgery?
  3. How long will the surgery take, and what is the expected recovery time?
  4. What type of colectomy surgery do you recommend for me or my child, and why?
  5. Are there any alternative treatments or surgical options available?
  6. How many colectomy surgeries have you performed, and what is your experience with the specific type of surgery recommended?
  7. What can I expect in terms of pain management after the surgery?
  8. Will I or my child need to make any lifestyle changes or follow a special diet after the surgery?
  9. What follow-up care will be needed after the surgery, and how long will it take to fully recover?
  10. Are there any long-term effects or considerations to be aware of after having a colectomy?

Reference

Authors: Martin G, Montalva L, Paré S, Ali L, Martinez-Vinson C, Colas AE, Bonnard A. Journal: J Robot Surg. 2023 Oct;17(5):2287-2295. doi: 10.1007/s11701-023-01647-2. Epub 2023 Jun 19. PMID: 37336840