Short summary

This is a single-center, single arm prospective study of short-term outcomes and specimen quality after right hemicolectomy when the stapled intracorporeal anastomosis (IA) is performed with the DaVinci Xi robot. Focus will be on postoperative recovery with length of hospital stay as the primary outcome measure. A historical cohort of patients undergoing laparoscopic right hemicolectomy with extracorporeal anastomosis will be used for comparison.

Rationale

In recent years laparoscopic right hemicolectomy (LRC) with extracorporeal anastomosis (EA) has become the standard treatment for right-sided colon cancer, with improved short-term morbidity and mortality compared with open surgery. It has been suggested that constructing the anastomosis laparoscopically within the abdomen (i.e.intracorporeal anastomosis, IA) could improve the outcome even further by avoiding the exteriorization of the bowel through a subcostal laparotomy for construction of the current EA. Recent systematic reviews and meta-analysis of IA versus EA in LRC has shown IA to be safe with less short term morbidity and decreased length of hospital stay (LOS). Performing IA safely with conventional laparoscopic technique is, however, rather difficult and time consuming which is probably why IA is still not widely used. The technical difficulty may be overcome by robotic-assisted laparoscopic right hemicolectomy (RARC).

With the most recent generation of robots, the DaVinci Xi, technical improvements have allowed for a reduction of the docking time, and operating time is not substantially longer. All cases in the published series were done with older versions of the DaVinci robot, and a new prospective study seems warranted to elucidate whether the expected benefits of RARC will emerge in a more modern perioperative setup with the most recent and advanced robot. We suggest the present study as a first step to form the basis for a subsequent large-scale randomized study.

Description of the cohort

Study group: 40 consecutive patients with verified or suspected right colon cancer planned for elective robot-assisted right hemicolectomy with curative intent. The first 5 patients will be regarded as a pilot series for testing and aligning the study setup, the next 35 patients will be the actual study group. Control groups: 35 recent patients undergoing LRC with EA, and 35 recent patients undergoing RARC with EA, both groups matched with the study group for age, sex and BMI.

Data and biological material

Clinical data on perioperative course and outcomes with LOS as the primary outcome measure.

Collaborating researchers and departments

Department of Surgery, Vejle Hospital

• Lars Bundgaard 
• Jesper Andersen 
• Søren Rattenborg
• Conny Jakobsen
• Hans B Rahr

Department of Pathology, Vejle Hospital

• Jan Lindebjerg

Department of Anaestesiology, Vejle Hospital

• Jacob Kuhn