eP159 - Robot-Assisted Colon and Rectal Surgery in Iceland

Sunday, June 2, 2024

9:54 AM – 9:59 AM ET, USA

Location: Baltimore Convention Center, Room 318-320

ePoster Presenter(s)

Hjordis Asta Gudmundsdottir, MD (she/her/hers)

Medical Doctor
The National University Hospital
The National University Hospital of Iceland
Reykjavik, Hofuoborgarsvaoio, Iceland

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

JA

Jorunn Atladottir, MD

Colon and rectal surgeon
Landspitali University Hospital
Reykjavík, Hofuoborgarsvaoio, Iceland

Disclosure information not submitted.

Author(s)

PM

Pall Helgi Möller, MD, PhD

Chief of General Surgery
University of Iceland
Reykjavik, Hofuoborgarsvaoio, Iceland

Disclosure information not submitted.
EV

Elsa Bjork Valsdottir, MD

Faculty, Assistant Professor
Landspitali University Hospital
Reykjavik, Hofuoborgarsvaoio, Iceland

Disclosure information not submitted.

Purpose/Background: Robotic surgery, a major surgical advancement in colorectal surgery since the turn of the century, was introduced in Iceland in 2016. The aim of the study is to describe the short-term effectiveness and safety of robotic-assisted colon and rectal surgery in Iceland. This has not been studied previously.Methods/Interventions: This is a population-based, single-center, retrospective cohort study including all patients who underwent robotic-assisted colorectal surgery in Iceland from 2016 to 2022. Patient and operative-related data, including complications and mortality, were collected from the medical and procedure records of Landspítali – The National University Hospital of Iceland.Results/Outcomes: A total of 210 patients were included. The average age was 66 years (range: 32-93) and 47% were men. Indications for surgery included the following: colon cancer in 45.2%, rectal cancer in 35.2%, diverticular disease in 12.4%, and other diseases in 7.2%. The annual number of operations increased during the study period. Before 2020 the most common operation was right hemicolectomy and after 2020 it was anterior resection. Operations performed were right hemicolectomy 28.2% (n=59), left colectomy 5.7% (n=12), sigmoidectomy 23.4% (n=49), anterior resection 31.1% (n=65), rectopexy 1.9% (n=4), and abdominoperineal resection 10% (n=21). The mean operative time was 211 minutes (range: 66-471). Intraoperative estimated blood loss of ≥300mL occurred in 4.3% of cases and 0.5% required blood transfusion. Intestinal injury occurred in 3.3% of cases. Conversions to laparoscopy occurred in 1.4% of cases and to laparotomy in 3.3%. The average length of stay was 4.5 days (range: 1-22). Minor postoperative complications rates (Clavien-Dindo 1-2) were 23.8% (n=50) and major complications rates (Clavien Dindo 3-5) were 6.7% (n=14), with the most common causes being anastomotic leak (n=4; 2%) and abscess formation (n=3; 1,4%). The readmission rate was 7.1%, most commonly due to suspicion of anastomotic leak (n=4; 2%) and perineal wound dehiscence (n=2; 1%). Reoperation was performed in 3.3% of cases (n=7). The thirty-day mortality rate was 0.5% (n=1).Conclusion/

Discussion: Robot-assisted colon and rectal surgery in Iceland is safe. Short-term outcomes are comparable to foreign studies. The rate of major complications and reoperations is low. The thirty-day mortality is low.Types of Robot-Assisted Colon and Rectal Surgeries in Iceland by Year

Clavien Dindo Classification of Short-Term Complications

No complications, Clavien Dindo 0, in 69.5% of cases. Complications occurred in 30.5% of cases.
Average Length of Stay and Readmissions