eP801 - Comparing Articulating Laparoscopic vs. Robotic Surgery in Rectal Cancer: Multicenter, Prospective Cohort Study (STARC trial)

ePoster Presenter(s)

• 

  Dae Hee Pyo, MD, PhD

  clinical assistant professor
  Catholic University of Korea Eunpyeong St. Mary's Hospital

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

Author(s)

• SK

  Seijong Kim, n/a

  Fellow
  Samsung Medical Center
  Seoul, Seoul-t'ukpyolsi, Republic of Korea

  Disclosure information not submitted.

Senior Author(s)

• JH

  Jung Wook Huh, M.D.

  Professor
  Samsung Medical Center, Sungkyunkwan University School of Medicine,
  Seoul, Seoul-t'ukpyolsi, Republic of Korea

  Disclosure information not submitted.

Author(s)

• YL

  Yoon Suk Lee, M.D

  Professor
  The Catholic univ
  Seoul, Seoul-t'ukpyolsi, Republic of Korea

  Disclosure information not submitted.
• BM

  Byung Soh Min, M.D.

  Professor
  Yonsei University College of Medicine
  Seoul, Seoul-t'ukpyolsi, Republic of Korea

  Disclosure information not submitted.
• JL

  Jaeim Lee, MD, PhD

  The Catholic University of Korea

  Disclosure information not submitted.
• CK

  Chang Hyun Kim, M.D.

  Professor
  Chonnam National University Hwasun Hospital and Medical School
  Hwasun, Cholla-namdo, Republic of Korea

  Disclosure information not submitted.
• HO

  Heung-Kwon Oh, n/a

  Professor
  Seoul National University Bundang Hospital
  Seongnam, Kyonggi-do, Republic of Korea

  Disclosure information not submitted.
• YY

  Yong Sik Yoon, M.D.

  Professor
  University of Ulsan College of Medicine and Asan Medical Center
  Seoul, Seoul-t'ukpyolsi, Republic of Korea

  Disclosure information not submitted.
• DB

  Donghwan Bae, n/a

  Director
  LIVSMED
  Suwon, Kyonggi-do, Republic of Korea

  Disclosure information not submitted.

Image or Table (Do Not add text here):

Purpose/Background: ArtiSentialⓇ, an innovative articulating laparoscopic instrument, offers significant advantages through its multiple degrees of freedom in movement, closely mirroring the capabilities of surgical robots. This resemblance facilitates enhanced dexterity within confined and intricate anatomical regions, notably the pelvis. Despite these advantages, comparative studies between ArtiSential and robotic surgical methodologies remain unexplored. This study aims to bridge this gap by evaluating the surgical and oncological outcomes of ArtiSential-assisted surgery versus robotic surgery in patients undergoing treatment for rectal cancer, thereby contributing valuable insights into the efficacy and applicability of ArtiSential in modern surgical practices. This is the interim results of this clinical trial.Methods/Interventions: A multicenter, prospective, comparative cohort study was conducted in October 2022. The study included patients with primary non-metastatic rectal adenocarcinoma who underwent articulating laparoscopic or robotic surgery, either with or without neoadjuvant chemoradiotherapy. The recruitment will be conducted until December 2024. Thus, we present the interim analysis of this clinical trial. The primary endpoint was 30-day overall morbidity. The secondary endpoints were severe morbidity defined as Clavien-Dindo ≥ III complications, mortality, procedure time for each surgical step, and quality of rectal specimens including completeness of total mesorectal excision (TME).Results/Outcomes: A total of 348 patients have been enrolled in ArtiSential (n = 124) or Robotic (n = 224) group. Most patients underwent low anterior resection, including 102 (82.3%) and 141 (62.9%) in ArtiSential and Robotic groups, respectively. Both groups showed similar overall 30-day complication rates, including 28 (22.6%) and 35 (15.6%) in ArtiSential and Robotic groups, respectively (P = 0.114). The severe complication rates were not significantly different between the groups (ArtiSential 14/124, 12.7% vs. Robotic 22/224, 10.9%, P = 0.805). There was no mortality within a month from surgery. Patients in Robotic group showed significantly longer total operation time, from skin incision to initiation of intraabdominal procedure (trocar placement for ArtiSential group and robot docking for Robotic group), total mesorectal excision (TME) time, and intraperitoneal phase time. The proportion of complete TME were similar in both groups (ArtiSential 115/124, 92.7% vs. Robotic 211/224/94.2%, P = 0.761).Conclusion/

Discussion: Both ArtiSential and Robotic surgery for rectal cancer are assumed to provide a technically superior operative environment to conventional laparoscopic surgery using rigid rod-like instruments. Due to ArtiSentials’ handiness and simple instructions compared to surgical robots, it also provides a shorter operation time without compromising the short-term surgical outcomes. We are also conducting a comparative cost analysis of ArtiSential and Robotic surgery. (Clinical trials identification: NCT05566249)Figure 1. Mesorectal excision using an articulating laparoscopic device, ArtiSentialFigure 2. Comparison of Procedure Time