Laparoscopic Versus Robotic Elective Sigmoid Resection for Complicated Diverticulitis

Objective: Minimally invasive surgical techniques for colorectal surgery have continued to grow in prevalence with robotic surgery potentially providing advantages in complex pelvic operations. We sought to examine the outcomes of laparoscopic versus robotic elective sigmoid colon resection for complicated diverticulitis. Methods: We performed a retrospective review of patients at an academic tertiary care center from 2018-2023 who underwent elective minimally invasive sigmoid colon resections for complicated diverticulitis. Multiple regression analysis was performed with primary outcomes being reoperation within 30 days and overall complications. Secondary outcomes included conversion to open, estimated blood loss, operative time, days until return of bowel function, and length of stay. Results: In this cohort of 131 patients, 38 underwent laparoscopic colectomy and 93 patients underwent robotic colectomy. There were no significant differences between rate of reoperation (7.7% vs 2.1%, P= .42), complications (5.1% vs 8.4%, P= .52), conversion to open (5.1% vs 2.1%, P= .25), days until return of bowel function (1.87 vs 2.01, P= .41), or length of stay (5.2 vs 5.2, P= .92). There were significant differences in operative time and estimated blood loss. Robotic approach was 128.11 minutes longer (/3 = 128.11, SE = 12, p < .001) and had 33.4 cc less estimated blood loss (/3 = -33.4, SE = 16.6, P = .046), when adjusting for other confounders. Conclusion: Robotic sigmoid colectomy for complicated diverticulitis had mostly equivalent outcomes at this institution. There was some decrease in estimated blood loss, however, operative time was increased in the robotic group.