A study of robot-assisted colectomies found that the procedure offered minimal safety benefit compared with laparoscopic colectomy and should continue to be questioned by surgeons and hospitals.
The trial was conducted because of the rapid increase in robotic surgery for common operations like colectomy, combined with a lack of evidence regarding its effectiveness. It was led by the University of Michigan Health Center’s Dr. Kyle Sheetz and published online yesterday in The Journal of the American Medical Assn.
The trial examined data from 191,292 elective colectomies of Medicare beneficiaries between January 2010 and December 2016; 23,022 of the procedures were robotic. The proportional use of robotic colectomy shifted from 0.7% in 2010 to 10.9% in 2019, according to the study. Robotic colectomy was associated with fewer overall complications than open surgery, even though there were higher rates of surgical complications in the robotic procedure, the study found.
However, there was no differences in complication rates between robotic and laparoscopic colectomy: Robotic procedures had a 17.6% rate of complications compared to 18.6% in open colectomies. And robotic colectomies replaced a greater proportion of minimally invasive laparoscopic surgeries than it did high-risk open procedures.
“While robotic colectomy was associated with minimal safety benefit over open colectomy and had comparable outcomes with laparoscopic colectomy, population-based trends suggest that it replaced a greater proportion of laparoscopic rather than open colectomy, especially in hospitals with the highest adoption of robotics,” the study’s authors concluded.