TPT 1.06 Robotic versus Laparoscopic Right Hemicolectomy: A Propensity-Matched Analysis from a UK Colorectal Unit

Abstract

Right hemicolectomy (RHC) is one of the most common colorectal-cancer-operations performed in the NHS. Although robotic platforms are becoming more available, it's unclear whether they offer any practical advantage over standard laparoscopy for this operation. We evaluated real-world outcomes from our unit to inform everyday-operative-decision-making. All elective oncological RHCs performed between Sept-2023–Feb-2025 were reviewed from theatre records. Only cancer cases were included; benign or non-resectional procedures were excluded. To allow a fair comparison, we performed propensity-score matching (1:1) using routinely available variables: age, BMI, ASA grade, comorbidity score (CCI), and gender. This produced 21 well-matched robotic–laparoscopic pairs. Continuous outcomes (operating time, theatre time, LOS) were compared using the Wilcoxon signed-rank test, and complications/readmissions using exact McNemar testing. Before-matching, there were 69 robotic and 36 laparoscopic RHCs. After matching, no meaningful differences were detected in any key peri-operative outcomes. Median operating time was 148 min (robotic)vs141 min (laparoscopic) (p=0.41). Median theatre time was 186vs173 min (p=0.45). Length of stay was similar: 4.0 vs 4.5 days(p=0.63). Complication rates were 19% (robotic) vs 33% (lap) (p=0.55), and readmission-rates were 14% vs 10% (p=1.00). For RHC in our unit, robotics did not demonstrate a measurable advantage over laparoscopy in operative time, LOS, or early-postoperative-outcomes. Laparoscopy remains an excellent first-line approach for most RHCs within the NHS, with robotics used selectively at the surgeon’s-discretion. Larger datasets are needed to evaluate cost-effectiveness and specific subgroups that may benefit.