S. B. Bryczkowski1, D. M. Filiberto2, S. G. Pereira1 1Hackensack University Medical Center,General Surgery,Hackensack, NJ, USA 2University Of Tennessee Health Science Center,Surgical Critical Care,Memphis, TN, USA
Introduction: Robot-assisted surgery is making its way into general surgery. There are currently no published data regarding single-site robot-assisted appendectomy. The purpose of this study was to evaluate and present our experience with robot-assisted single-single site appendectomy (RA) and compare it to laparoscopic appendectomy (LA) to determine the safety and cost effectiveness.
Methods: A single institution retrospective review was conducted from August 2013 to August 2014. Adult patients with the clinical diagnosis of acute appendicitis were included in the study. The intervention was either immediate appendectomy (RA or LA) for uncomplicated appendicitis or interval appendectomy (RA or LA) for complicated appendicitis. The primary outcomes were complications and cost. Secondary outcomes were length of stay (LOS), operative time, and estimated blood loss (EBL).
Results: Of the 22 patients who underwent appendectomy for appendicitis, 7 underwent RA and 15 LA. Cohorts were similar in terms of age (41.8 vs 42.4), gender (71 vs 60% female), and BMI (27.3 vs 27.8 kg/m2). There was one complication in the LA group and none for RA. The cost of RA was less than that of LA ($1,168 vs $1,932). Patients who underwent RA had longer operative times compared to LA (111 vs 54 minutes), similar blood loss (13.6 vs 18.6mL) and shorter LOS (0.86 vs 1.3 days).
Conclusion: Appendicitis is a common surgical diagnosis. While Robot-assisted single-site appendectomy does have a longer operative time, this study showed that it is a safe and cost effective alternative compared to laparoscopic appendectomy.
