Impact of team experience on robot-assisted surgery for rectal cancer: A comparative study

Abstract

Introduction

The robotic surgical team in the operating room plays an important role in determining the outcome of a robotic approach. This study aimed to compare the outcomes of 2 hospitals with different levels of expertise in robot-assisted rectal cancer surgery.

Methods

This retrospective study analyzed 195 patients who underwent robot-assisted rectal resection at 2 referral centers for the treatment of rectal cancer between March 2018 and December 2021.

Results

In total, 195 patients had undergone robotic rectal cancer surgery: 95 performed by an expert team, and 100 by a novel team. The expert team performed more low anterior resections (55.8%) than the novel team (33%) (P = 0.001), and the total operative time varied significantly between the groups (P < 0.001). The novel team’s operative time was 135 min longer than the expert team’s. The expert team had no conversions to open surgery, while the novel team had an 8% conversion rate (P = 0.007). In this study, overall morbidity was 45.3% among patients treated by the expert team versus 38% among those treated by the novice team (P = 0.304). Severe complications (Clavien–Dindo grade >IIIB) occurred at a rate of 10% in both groups. Incomplete mesorectal excision was observed in 3.2% of the expert team’s patients versus 4.2% of the novice team’s (P = 0.65).

Conclusion

The expert team achieved a shorter operative time and less conversion to open surgery. However, the morbidity and pathological outcomes were comparable between the teams. The introduction of robotic surgery in a team with early-stage surgical experience was safe.