Comparison of the operative outcomes and learning curves between laparoscopic and "Micro Hand S" robot-assisted total mesorectal excision for rectal cancer: a retrospective study

Yanlei Wang, Guohui Wang, Zheng Li, Hao Ling, Bo Yi, Shaihong Zhu, Yanlei Wang, Guohui Wang, Zheng Li, Hao Ling, Bo Yi, Shaihong Zhu

Abstract

Background: The Micro Hand S robot is a new surgical tool that has been applied to total mesorectal excision (TME) surgery for rectal cancer in our center. In this study, we compared the operative outcomes, functional outcomes and learning curves of the Micro Hand S robot-assisted TME (RTME) with laparoscopic TME (LTME).

Methods: A total of 40 patients who underwent RTME and 65 who underwent LTME performed by a single surgeon between July 2015 and November 2018 were included in this retrospective study. Clinicopathologic characteristics, operative and functional outcomes, and learning curves were compared between the two groups. The learning curve was analyzed using the cumulative sum method and two stages (Phase 1, Phase 2) were identified and analyzed. All patients were followed up for at least 12 months.

Results: The clinicopathologic characteristics of the two groups were similar. The learning curve was 17 cases for RTME and 34 cases for LTME. Compared with LTME, RTME was associated with less blood loss (148.2 vs. 195.0 ml, p = 0.022), and shorter length of hospital stay (9.5 vs. 12.2 days, p = 0.017), even during the learning period. With the accumulation of experience, the operative time decreased significantly from Phase 1 to Phase 2 (RTME, 360.6 vs. 323.5 min, p = 0.009; LTME, 338.1 vs. 301.9 min, p = 0.005), whereas other outcomes did not differ significantly.

Conclusions: Micro Hand S robot-assisted TME is safe and feasible even during the learning period, with outcomes comparable to laparoscopic surgery but superior in terms of blood loss, length of hospital stay, and learning curve. Trial registration Clinicaltrial.gov, NCT04836741, retrospectively registered on 5 April 2021.

Keywords: Laparoscopic surgery; Micro Hand S surgical robot system; Rectal cancer; Robotic surgery; Total mesorectal excision.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The Micro Hand S surgical robotic system. Surgeon console (right): (1) image display device, (2) master arm, (3) control panel. 3D imaging system (middle). Slave surgical cart (left): (4) electrical control system, (5) lifting column, (6) suspension passive arm, (7) swivel head, (8) slave arm
Fig. 2
Fig. 2
The flow chart of patient selection
Fig. 3
Fig. 3
The arrangement of the surgical ports for RTME
Fig. 4
Fig. 4
The IPSS score for RTME and LTME in male patients. *p < 0.05 for difference in mean scores between preoperatively and each time point
Fig. 5
Fig. 5
The IIEF-5 score for RTME and LTME in male patients. *p < 0.05 for difference in mean scores between preoperatively and each time point
Fig. 6
Fig. 6
The learning curves for RTME and LTME. The curve of RTME reached the peak point at the 17th case; and the curve of LTME reached the peak point at the 34th case

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Source: PubMed

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