Robotic Versus Laparoscopic Sigmoid Resection for Diverticular Disease: A Single-Center Experience of 106 Cases

Background: Laparoscopic sigmoid resection is the surgical standard for the treatment of diverticulitis. Robotic sigmoid resection with the da Vinci Xi (R) platform may offer advantages over the laparoscopic approach. Materials and Methods: One hundred and six patients with uncomplicated, complicated, or recurrent diverticular disease underwent robotic (n = 60) or laparoscopic (n = 46) sigmoid resection at our institution between 2013 and 2018. Patient demographics and characteristics, perioperative measures, and complications were retrospectively analyzed. Results: There were no statistically significant differences between the robotic and laparoscopic group with regard to operative time (130 versus 118 minutes; P = .23), anastomotic leakage (6.7% versus 6.5%; P = 1.0), need for stoma (6.7% versus 4.3%; P = 1.0), conversion rate (1.7% versus 0%; P = .36), reoperation (8.3% versus 15.2%; P = .27), overall complications according to the Clavien-Dindo classification (30.0% versus 30.4%; P = .8), mortality (1.7% versus 0%; P = 1.0), and need for intravenous analgesics (3.0 versus 2.1 days; P = .21). The duration of postoperative ileus was significantly shorter in the robotic group (2.2 versus 2.8 days; P = .01). Conclusion: Robotic sigmoid resection for uncomplicated, complicated, or recurrent diverticular disease is a safe and feasible procedure. However, robotic sigmoid resection for diverticulitis is not associated with relevant clinical benefits for patients compared to laparoscopic resection except for a slightly shorter duration of postoperative ileus.