Our Summary

This research paper studied surgical procedures involving the removal of the appendix (appendectomies) and gallbladder (cholecystectomies), comparing traditional methods (laparoscopic) and newer, robotic-assisted methods. Two experienced surgeons carried out these procedures over two years to see how they compared in terms of how long the operation took, how long it took for patients to be discharged, if they needed to switch to an open surgery during the procedure, and if patients needed to be readmitted within a month of the surgery.

The study found that the time it took to do the surgery was nearly the same for both methods, but patients who had the robotic-assisted surgery were able to leave the hospital sooner. Also, in some cases, surgeons had to switch from a laparoscopic to an open surgery, but this was not required for any of the robotic-assisted surgeries. Lastly, there were a few cases where patients had to be readmitted to the hospital after their surgery, but this happened almost equally between the two methods.

In summary, the study shows that robotic-assisted surgeries are not longer than traditional methods, allow patients to leave the hospital sooner, and decrease the chance of needing to switch to an open surgery during the procedure.

FAQs

  1. Is the intraoperative time for a robotic-assisted appendectomy longer than a laparoscopic appendectomy?
  2. Does a robotic-assisted approach decrease the time to discharge compared to a laparoscopic approach in appendectomies and cholecystectomies?
  3. Were there any cases of conversion to open procedures for robotic-assisted appendectomies and cholecystectomies compared to laparoscopic procedures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic appendectomy is that compared to robotic-assisted appendectomy, laparoscopic approach may have a slightly longer intraoperative time but typically results in a shorter time to discharge and lower risk of conversion to an open procedure. It is important to discuss the benefits and risks of each approach with your surgeon to determine the best option for you.

Suitable For

Patients who are typically recommended for laparoscopic appendectomy are those with acute appendicitis, as the laparoscopic approach has been shown to have shorter hospital stays, less postoperative pain, and faster recovery compared to open surgery. Additionally, patients who are young, healthy, and have a low risk for complications may also be good candidates for laparoscopic appendectomy.

Patients who are not recommended for laparoscopic appendectomy include those with severe peritonitis, abscess formation, or other complications that may require a more extensive surgical approach. In these cases, open surgery may be necessary to ensure the best outcome for the patient.

Overall, the decision to recommend laparoscopic appendectomy will depend on various factors, including the patient’s overall health, the severity of their condition, and the surgeon’s expertise in performing the procedure.

Timeline

  • Before laparoscopic appendectomy: The patient typically experiences symptoms of appendicitis such as abdominal pain, nausea, and vomiting. They may undergo imaging tests to confirm the diagnosis.

  • During laparoscopic appendectomy: The patient is put under general anesthesia and small incisions are made in the abdomen for the insertion of a camera and surgical instruments. The appendix is removed and the incisions are closed with sutures or staples.

  • After laparoscopic appendectomy: The patient may stay in the hospital for a day or two for observation. They will be given pain medication and instructions for wound care and activity restrictions. Most patients can resume normal activities within a week.

  • Before laparoscopic cholecystectomy: The patient typically experiences symptoms of gallbladder disease such as abdominal pain, bloating, and nausea. They may undergo imaging tests to confirm the diagnosis.

  • During laparoscopic cholecystectomy: The patient is put under general anesthesia and small incisions are made in the abdomen for the insertion of a camera and surgical instruments. The gallbladder is removed and the incisions are closed with sutures or staples.

  • After laparoscopic cholecystectomy: The patient may stay in the hospital for a day or two for observation. They will be given pain medication and instructions for wound care and dietary restrictions. Most patients can resume normal activities within a week.

What to Ask Your Doctor

  1. What are the benefits of a laparoscopic appendectomy compared to a traditional open appendectomy?

  2. How long does a laparoscopic appendectomy typically take to perform?

  3. Are there any potential risks or complications associated with a laparoscopic appendectomy?

  4. How long can I expect to stay in the hospital after a laparoscopic appendectomy?

  5. What is the recovery process like after a laparoscopic appendectomy?

  6. How soon can I resume normal activities, such as work or exercise, after a laparoscopic appendectomy?

  7. Are there any dietary restrictions I should follow after a laparoscopic appendectomy?

  8. Will I have any visible scars after a laparoscopic appendectomy? If so, how can I minimize their appearance?

  9. How does a robotic-assisted appendectomy compare to a traditional laparoscopic appendectomy in terms of cost and outcomes?

  10. Are there any specific criteria that would make me a better candidate for a robotic-assisted appendectomy over a laparoscopic 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