Short-term clinical outcomes and cost analysis of intracorporeal anastomosis with laparoscopic and robotic staplers during robot-assisted right colon resection: a single-center retrospective study
摘要
Intracorporeal anastomosis has become a routine component of robot-assisted right colectomy, but comparative data between the robotic stapler (RS) and the laparoscopic stapler (LS) remain scarce. This study analyzed procedural efficiency and short-term clinical outcomes of these two techniques, with particular attention to stapler utilization and economic considerations. A retrospective review was performed for 140 consecutive patients who underwent robotic right colectomy with intracorporeal bowel reconstruction between Jan 2023 and Mar 2025 at our center. Among these, RS was used in 62 operations, while LS was applied in 78 procedures performed with assistance at the bedside. Of the 140 cases, functional end-to-end anastomosis was employed in 91, Delta in 33, and Overlap in 16, with similar distributions between the RS and LS groups. Median operative duration was shorter in the LS cohort (182 min) compared with the RS group (201.5 min, p = 0.033). Other perioperative parameters—including blood loss, complication profile, hospital recovery time, and pathology—did not differ meaningfully between the two techniques. However, the LS approach required fewer stapler firings (4 vs. > 5, p < 0.001), while the time required to complete the anastomosis was nearly identical (14 min in both groups, p = 0.44). Both stapling systems provided safe and reliable outcomes in robotic right colectomy. The LS strategy reduced the number of stapler applications without prolonging anastomosis, suggesting a potential for improved operative efficiency. These results support the need for larger, prospective evaluations to confirm these findings.