Robotic Right and Left Colectomies: Extra- or Intracorporeal Anastomosis

Introduction Robotic right and left hemicolectomies for colon cancer are among the most common surgical procedures. In the past decades they began to be performed laparoscopically and in recent years—by robotic surgical systems. Despite the enhanced recovery protocols and minimal invasiveness of the procedure, there are still complications. Robotic right and left hemicolectomies with an intracorporeal anastomosis (ICA) are less invasive than the same robotic-assisted procedures, and could lead to fast recovery and shortening of the postoperative period. Aim The aim of the study is to evaluate the feasibility and safety of the intracorporeal anastomosis after robotic left and right colectomies. Results and Discussion: Surgical time was found to be insignificantly shorter in the intracorporeal anastomosis group: 125.1 ± 37.1 vs. 128.2 ± 21.1 for right colectomy and 147.3 ± 39.1 vs. 153.8 ± 58.1 for left colectomy. Many studies show similar results, but the advantages of intracorporeal anastomosis evaluated by visual analog scale (VAS) are even more significant. Our results did not indicate significant difference in number of harvested lymph nodes: 24.9 ± 11.3 vs. 25.1.9 ± 10.1 and 26.8 ± 9.3 vs. 25.9 ± 11. Anastomotic leakage in extracorporeal anastomosis (ECA) after left colectomy was significantly higher: 2 (11.7%), < 0.001. Wound infections in our patients again were insignificantly higher in ECA 0.0 vs. 1 (4.2%) in right and 1 (6.2%) vs. 1 (5.9%) in left colon. Overall hospital stay was also significantly shorter in ICA left colectomies and insignificantly in right ones: 7.0 ± 4.9 vs. 7.8 ± 4.1, P = 0.217, and 6.1 ± 2.5 vs. 8.0 ± 4.9, P < 0.001. Conclusion: The results of our study confirmed the literature data that ICA after colon resection is a safe and feasible procedure, accepted by many colorectal surgeons