Safe adoption of robotic colorectal surgery using structured training: early Irish experience

 

12.12.2018

Beacon Hospital in Dublin, Ireland publishes a paper on the safe adoption of robotic colorectal surgery using the EARCS structured training programme

 

 

Today, the EARCS trained team at Beacon Hospital in Dublin, Ireland announced the publication of a new paper in the Journal of Robotic Surgery. This manuscript describes Beacon Hospital's institutional experience with the adoption of robotic colorectal surgery for a variety of benign and malignant conditions following the training structure outlined by the European Academy of Robotic Colorectal Surgery (EARCS).

Analysis was conducted of a prospectively maintained database of the first 55 consecutive robotic colorectal cases, performed by four colorectal surgeons, each at the beginning of his robotic surgery experience, using the Da Vinci Si® system and undergoing training as per the EARCS programme. Overall surgical and oncological outcomes were interrogated. Fifty-five patients underwent robotic surgery between January 2017 and January 2018, M:F 34:21, median age (range) 60 (35–87) years. Thirty-three patients had colorectal cancer and 22 had benign pathologies. Eleven rectal cancer patients had neoadjuvant chemoradiotherapy. BMI was > 30 in 21.8% of patients and 56.4% of patients had previous abdominal surgery. Operative procedures performed were low anterior resection (n = 19), sigmoid colectomy (n = 9), right colectomy (n = 22), ventral mesh rectopexy (n = 3), abdominoperineal resection (n = 1) and reversal of Hartmann’s procedure (n = 1). Median blood loss was 40 ml (range 0–400). Mean operative time (minutes) was 233 (SD 79) for right colectomy and 368 (SD 105) for anterior resection. Median length of hospital stay was 6 days (IQR 5–7). There was no 30-day mortality, intraoperative complications, conversion to laparoscopic or open, or anastomotic leakage. Median lymph nodes harvest was 15 in non-neoadjuvant cases (range 7–23) and 8 in neoadjuvant cases (2–14). These early results demonstrate that colorectal robotic surgery can be adopted safely for both benign and neoplastic conditions using a structured training programme without compromising clinical or oncological outcomes. The early learning curve can be time intensive.

EARCS is very proud to have been part of this landmark paper. Congratulations to everyone involved in the study!