Oliva Adams
Introduction
Robotic-assisted colectomy is increasingly adopted in colorectal surgery; however, its benefit over laparoscopic colectomy in reducing post-operative complications remains debated. This systematic review evaluated whether robotic-assisted colectomy offers superior short-term outcomes.
Methods
A systematic search of PubMed, Embase, and Cochrane databases from 2000 to 2025 identified studies comparing robotic-assisted and laparoscopic colectomy. Randomised controlled trials, cohort studies, meta-analyses, and systematic reviews were included. Case reports, hybrid procedures, non-colectomy colorectal operations were excluded. Outcomes assessed included overall and specific postoperative complications, conversion to open surgery, operative time, blood loss, and length of hospital stay.
Results
Fifteen studies comprising over 200,000 patients were included. Robotic-assisted colectomy demonstrated consistently lower overall post-operative complication rates, with reductions of 22–38% and odds ratios ranging from 0.62 to 0.78. Wound infection rates were lower in robotic procedures compared with laparoscopic procedures at 4.7% versus 6.4%. Conversion to open surgery occurred significantly less frequently with robotic techniques, with odds ratios between 0.34 and 0.56. Robotic colectomy was also associated with reduced intraoperative blood loss of approximately 16–19 mL and shorter hospital stays of
0.6–0.8 days. No significant differences were observed in anastomotic leak rates, mortality, reoperation, or readmission. Operative times were longer for robotic procedures, with mean increases of 39–53 minutes and higher associated costs.
Conclusion
Robotic-assisted colectomy is associated with reduced overall post-operative complications and improved perioperative outcomes compared with laparoscopic colectomy, though at the expense of longer operative time and increased cost. Further high-quality randomised studies are required internationally
Authors
Olivia Adams, Saffren Colbourne, Chloe Stevenson
University of Buckingham, Buckingham, United Kingdom