Abstract
Background. Complete mesocolic excision (CME) is a surgical technique introduced with the aim of ameliorating the oncologic results of colectomy. Various experiences have demonstrated favorable oncologic results of CME in comparison with standard colectomy, in which the principles of CME are not respected. The majority of the literature refers to open or laparoscopic CME. This review analyses current evidence regarding robotic CME for right colectomy. Methods. An extensive Medline (Pub Med) search for relevant case series, restricted to papers published in English, was performed, censoring video vignettes and case reports. Results. Fourteen studies (ten retrospective, four comparative series of robotic versus laparoscopic CME) were included, with patient numbers ranging from 20 to 202. Four different approaches to CME are described, which also depend on the robotic platform utilized. Intraoperative and early clinical results were good, with a low conversion and anastomotic leak rate and a majority of Clavien–Dindo complications being Grades I and II. Oncologic adequacy of the surgical specimens was found to be good, although a homogeneous histopathologic evaluation was not provided. Conclusions. Further large studies are warranted to define long-term oncologic results of robotic right colectomy with CME and its eventual benefits in comparison to laparoscopy.
Highlights
Intraoperative complications were only reported by Yozgatli [26], who described two cases of minor vascular injuries that were repaired robotically and did not require conversion to open surgery
22% and no significant differences found in the four comparative studies of robotic versus laparoscopic Complete mesocolic excision (CME)
Adequacy of resection was mainly evaluated by reporting the median number of harvested lymph nodes, which totalled 32 considering all the studies; in the comparative series published by Ngu [25] and Yozgatli [26], significantly more lymph nodes were retrieved in the robotic group in comparison with the laparoscopic group (41 vs. 31 and 41 vs. 33, respectively), while differences were not significant in the remaining two comparative series
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Complete mesocolic excision (CME) with central vessel ligation (CVL) is a surgical technique first described by West [1] in 2008 and Hohenberger [2] in 2009
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