Robot-assisted Right Colectomy With Lymphadenectomy and Intracorporeal Anastomosis for Colon Cancer: Technical Considerations

Background: A surgical robot (the da Vinci system) was developed to overcome the disadvantages of laparoscopic surgery, and applications of this system have been widely used. In this study, we present our standardized technique of robotic right colectomy with lymphadenectomy and intracorporeal anastomosis, with an assessment of feasibility in a series of 15 patients. Methods: All robotic right colectomies with lymphadenectomy were performed by a single surgeon between April 2009 and March 2010. Robotic assistance was used for the colonic mobilization, lymphadenectomy, and bowel reconstruction. Patient demographics, perioperative clinical outcomes, and pathologic results were reviewed. Results: Robotic-assisted right colectomy was successfully performed on 15 patients with colon cancer. The total operative time was 201.4 +/- 8.1 minutes, with a mean robotic time of 114.4 +/- 7.5 minutes. No patient required conversion to conventional surgery. The median time to clear liquid intake was 3 days, and the median length of stay after surgery was 8 days. The mean tumor diameter was 3.0 +/- 0.3 cm, and the mean number of harvested lymph nodes was 24.2 +/- 15.5. Tumors were diagnosed as stage I in 7 patients, stage II in 5, and stage III in 3. Conclusions: Robotic right colectomy with lymphadenectomy can be performed successfully and safely. The robotic system was safe and feasible for the following steps: accurate node dissection, suturing for intracorporeal anastomosis, and natural orifice specimen extraction. Further comparative studies must be performed to verify the advantages of robotic surgery over conventional laparoscopic surgery.