Abstract

The purpose of this systematic review was to identify differences in perioperative variables (oncologic and financial) between the laparoscopic and robotic-assisted approaches to hemicolectomy. In accordance with the PRISMA guidelines, a comprehensive literature search was conducted from inception through May 2024. Eligible articles included comparative analyses between laparoscopic and robotic-assisted hemicolectomy in an adult population with either a benign or malignant diagnosis. Variables studied included postoperative complications, length of stay (LOS), surgical time, conversion rate, lymph node harvest, cost, and survival. Six total articles met criteria for inclusion, five being retrospective cohorts and one was a pilot randomized controlled trial. The robotic-assisted hemicolectomy had longer surgical times and greater overall expense than the laparoscopic. On the other hand, robotic-assisted hemicolectomy might have some advantages, including lower conversion to open surgery rates, less intraoperative blood loss, and shorter LOS in some populations. No differences were observed between robotic-assisted versus laparoscopic approaches regarding key safety variables. The findings of one study indicated that robotic-assisted hemicolectomy was associated with a greater yield on lymph nodes than open surgery; however, when long-term overall survival and disease-free survival rates were compared, they were similar between robotic-assisted surgery and open surgery. It might be concluded that while robotic-assisted hemicolectomy had certain technical advantages over traditional laparoscopic techniques (such as decreased conversion rates) and appeared to be as safe for cancer patients, its advantages are overshadowed by the considerably longer operative durations and higher costs (economic and environmental).

Key words: Robotic-assisted surgery, laparoscopic surgery, hemicolectomy, postoperative complications, treatment outcome, systematic review.