TPW 1.13 Robotic Versus Laparoscopic Colectomy: A Propensity-Matched Comparative Study from a UK Colorectal Unit

Abstract

Robotic surgery is increasingly used for colorectal resections, yet its role outside complex pelvic dissection remains uncertain. This study compared peri-operative outcomes of robotic and laparoscopic colectomies (excluding right hemicolectomy) performed at a UK tertiary centre. A retrospective-review was undertaken of all oncological left hemicolectomies, sigmoid colectomies, total colectomies and other segmental colectomies performed between September 2023 and February 2025. Right hemicolectomies and benign cases were excluded. Primary outcomes were operating time and theatre time; secondary outcomes included length of stay (LOS), postoperative complications, and 30-day readmission. To minimise selection bias, propensity-score matching (1:1, caliper 0.1 SD) was performed using age, BMI, ASA grade, Charlson Comorbidity Index, and gender. Paired continuous outcomes were compared using the Wilcoxon signed-rank test, and binary outcomes using exact McNemar testing. A total of 42 eligible colectomies were identified (20 robotic, 22 laparoscopic). Six matched pairs were generated. Median operating time was 194 min (robotic) versus 186 min (laparoscopic) (p = 0.84). Median theatre time was 244 min vs 228 min (p = 0.84). LOS showed a non-significant trend favouring robotics (3.0 vs 4.0 days, p = 0.20). Complication rates were 33.3% vs 16.7% (p = 1.00), and readmission rates 0% vs 16.7% (p = 1.00). In this matched analysis, robotic colectomy demonstrated no statistically significant advantages over laparoscopy in operative efficiency or postoperative recovery. The small sample limits definitive conclusions. Larger multicentre datasets are needed to clarify whether specific colectomy subgroups benefit from robotic assistance.