Robotic surgery is a viable and sometimes advantageous approach for emergency colorectal surgery, a setting in which it has previously been underused and understudied, according to new research findings published in the Journal of the American College of Surgeons.

Emergency colorectal surgery traditionally employs open approaches, with limited adoption of minimally invasive techniques. While robotic surgery demonstrates benefits in elective procedures, its role in emergency settings has remained unclear. Researchers from the United States, Italy, and Belgium recently evaluated the outcomes of robotic versus laparoscopic and open approaches in emergency colorectal procedures and predicted future adoption trends.

The research team used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to analyze 83,483 patients who underwent emergency colorectal surgery. Included were 53,731 open, 26,649 laparoscopic, and 3,103 robotic procedures.

Study results

• Robotic surgery is gaining traction in emergency settings, representing 6.6% of colorectal surgeries in 2021.
• There are lower conversion rates when robotic surgery is compared to open surgery (7.8% vs. 24.2% for laparoscopy) and shorter postoperative stays.
• Patient selection is crucial; robotic surgery is preferred for stable patients with conditions like diverticulitis and non-septic cancer cases.
• A projected increase to 20.2% utilization of a robotic approach in 2025 indicates growing acceptance.
• Investment in robotic platforms is justified by improved outcomes, though challenges such as availability and training remain.

The study’s authors concluded that robotic surgery is a viable approach for emergency colorectal surgery, with lower conversion rates to open surgery and improved postoperative outcomes compared to both laparoscopic and open approaches. The projected increase in robotic utilization reflects growing acceptance of this technology, suggesting that its technical advantages may extend to more complex emergency cases than previously considered, according to the researchers.