Laparoscopic Versus Robotic Right Colectomy: A Two-Year Comparative Outcome Analysis From a Single High-Volume Center

Background Minimally invasive approaches have become standard in colorectal surgery, with laparoscopic and robotic-assisted techniques associated with reduced postoperative pain, accelerated recovery, and shorter hospitalization. Laparoscopy has been established for several decades, whereas robotic surgery is increasingly adopted due to enhanced instrument articulation, improved ergonomics, and three-dimensional visualization. This study aimed to compare perioperative and postoperative outcomes of robotic (rRC) versus laparoscopic (lapRC) right colectomy. Aims A single-center cohort analysis of a prospectively maintained database was performed, including all patients undergoing elective right colectomy for malignant disease between January 2023 and January 2025. Patients were stratified according to operative approach (lapRC vs. rRC). Continuous variables were evaluated using independent t-tests and categorical variables using Fisher’s exact test. Statistical significance was defined as p<0.05. Methods A single-center cohort analysis of a prospectively maintained database was performed, including all patients undergoing elective right colectomy for malignant disease between January 2023 and January 2025. Patients were stratified according to operative approach (lapRC vs. rRC). Continuous variables were evaluated using independent t-tests and categorical variables using Fisher’s exact test. Statistical significance was defined as p<0.05. Results In total, 159 patients met inclusion criteria (lapRC n=89; rRC n=70). Mean operative duration was significantly longer in the rRC group (298 min; SD 103.82) compared with lapRC (218 min; SD 72.42; p<0.001). Conversely, conversion to open surgery was markedly lower following rRC (1.4% vs. 18%; p<0.001). Length of stay was shorter in the rRC cohort (7.6 vs. 11.6 days), although this difference did not reach statistical significance (p=0.303). Postoperative morbidity, quantified using the Comprehensive Complication Index, demonstrated no significant differences (rRC 7.8 vs. lapRC 9.1; p=0.5813), and anastomotic leak rates were comparable (2.9% vs. 4.5%; p=0.695). Conclusion Robotic right colectomy appears to reduce conversion to open surgery relative to conventional laparoscopy but is associated with prolonged operative time. Postoperative recovery profiles and complication rates were similar, suggesting that robotic-assisted right colectomy is a safe and viable minimally invasive alternative. These findings support the expanding integration of robotic platforms in colorectal surgery. However, randomized controlled trials are needed to validate oncologic equivalence, assess long-term functional outcomes, and determine cost-effectiveness.