key: cord-0853634-c4a7h4ab
authors: Maertens, Vicky; Stefan, Samuel; Rawlinson, Emma; Ball, Chris; Gibbs, Paul; Mercer, Stuart; Khan, Jim S.
title: Emergency robotic colorectal surgery during COVID-19 pandemic: A retrospective case series study
date: 2022-03-22
journal: Laparosc Endosc Robot Surg
DOI: 10.1016/j.lers.2022.03.001
sha: 19cb6133db5fdb1afc10a4433e0a85c9518dbd16
doc_id: 853634
cord_uid: c4a7h4ab

OBJECTIVE: While interest in elective robotic surgery is growing, use in emergency setting remains limited due to challenges posed by sicker patients, advanced pathology and logistical issues. During the COVID-19 pandemic, robotic surgery could provide the benefit of having the surgeon away from the bedside and reducing the number of directly exposed medical staff. The objective of this study was to report patient outcomes and initial learning experience of emergency robotic colorectal surgery during the COVID-19 pandemic. METHODS: A case series study was conducted, including patients undergoing emergency robotic colorectal surgery between February 2020 and February 2021 at Queen Alexandra Hospital in Portsmouth, UK. Patient data were collected from an ethics approved prospective database. Patient demographics, operative time, conversions and postoperative complications were recorded. In addition, readmissions, length of stay and short-term oncological outcomes were analyzed. RESULTS: Ten patients with median age 64 y (range, 36 – 83 y) were included. Four patients had robotic complete mesocolic resection for obstructing cancers. Six had colorectal resections for benign disease in emergency setting. All were R0 with a mean lymph node harvest of 54 ±13. Mean operative time was 249 ± 117 min, the median length of stay was 9.4 d (range, 5—22 d). Only one patient was given a temporary diverting ileostomy. There were no grade III/V complications and no 30-day mortality. CONCLUSIONS: Provided an experienced team and peri-operative planning, emergency robotic colorectal surgery can achieve favorable outcomes with benefits of radical lymph node dissection in oncological cases and avoidance of diverting stoma.

The robotic platform addresses many of the technical and ergonomic limitations of laparoscopic 29 surgery(1), and results in reduced conversions, faster recovery and shortened hospital stay(2). Difficult 

Use of Robotic Technology in the Management of Complex 206

Long-term oncologic outcomes of robotic low anterior 208 resection for rectal cancer: a comparative study with laparoscopic surgery

the COVID-19 pandemic, especially for gynecological cancer: a statement of the Society of European 220

Robotic Gynaecological Surgery (SERGS)

Emergency and weekend robotic surgery are feasible

Single-Site Robotic Cholecystectomy: The 224 Timeline of Progress

Urgent and Elective Robotic Single-226

Site Cholecystectomy: Analysis and Learning Curve of 150 Consecutive Cases

Robotic right 229 colectomy for hemorrhagic right colon cancer: a case report and review of the literature of minimally 230 invasive urgent colectomy

Urgent robotic mesocolic excision for obstructing proximal transverse 232 colon cancer -a video vignette

Early 234 experience with urgent robotic subtotal colectomy for severe acute ulcerative colitis has comparable 235 perioperative outcomes to laparoscopic surgery

Systematic review of emergency laparoscopic 237 colorectal resection

Can we respect the principles of oncologic 239 resection in an emergency surgery to treat colon cancer?

Emergency Surgery During COVID-19 Pandemic

What Has Changed in Practice?

ESPEN guideline: Clinical nutrition in surgery

The use of indocyanine green fluorescence to assess 249 anastomotic perfusion during robotic assisted laparoscopic rectal surgery

Outcomes of Minimally Invasive Colectomy for Perforated Diverticulitis

Robotic Versus Laparoscopic Minimally Invasive Surgery 255 for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Short-and medium-term outcome of robot-assisted and traditional laparoscopic rectal resection