FTP3.6 Robotic Assisted Surgery – the future for patients with increased BMI?

Abstract

Abstract Introduction Obesity increases the technical difficulty of laparoscopic colorectal surgery. The ROLAR trial concluded robotic assisted surgery (RAS) did not significantly reduce the risk of conversion to open surgery in rectal cancer resections. In Scotland, in 2021, 30% of adult population were obese (BMI ≥30kg/m2) and 4% morbidly obesity (BMI ≥40kg/m2.) We describe local experience of laparoscopic surgery and RAS in the obese population. Methods Retrospective review of patients with obesity (BMI ≥30kg/m2) undergoing laparoscopic and robotic colorectal surgery by three colorectal surgeons. Conversion to open, 30-day morbidity and mortality and length of stay were assessed. Results 30 patients undergoing laparoscopic surgery and 37 patients undergoing RAS. Procedures include anterior resection; Hartmann’s procedure; left and right hemicolectomy, sigmoid colectomy, APER, subtotal colectomy, panproctocolectomy and completion proctectomy for benign and malignant conditions. Conclusions RAS resulted in fewer conversions to open procedures compared to laparoscopic surgery in the obese population. Fewer complications and returns to theatre in RAS group. The increased length of stay in RAS group can be explained by geographic considerations (25 RAS patients live >2 hours from hospital).