According to a study conducted in the United Kingdom, robotic surgery may reduce the likelihood of hospital readmission by more than 50% and the prevalence of blood clots by 77% when compared to patients who undergo open surgery.
The study, published in the Journal of the American Medical Association (JAMA), also discovered that after a robotic surgery, patients’ physical activity (as measured by daily steps tracked on a wearable smart sensor), stamina, and quality of life improved.
Researchers are now urging the National Institute of Clinical Excellence (NICE) to make robot-assisted surgery available as a clinical option across the UK for all major abdominal surgeries, including colorectal, gastro-intestinal, and gynaecological procedures, based on the findings.
“This is a significant discovery.” When using this advanced surgery, patients spend less time in the hospital and recover faster,” said study co-chief investigator James Catto, a professor at the University of Sheffield in the United Kingdom.
“In the end, this will reduce bed pressures and allow patients to return home sooner.” We are seeing fewer complications as a result of the increased mobility and decreased time spent in bed,” Catto said in a statement.
Despite the fact that robot-assisted surgery is becoming more widely available, no significant clinical evaluation of its overall benefit to patient recovery has been conducted.
“In this study, we wanted to see if robot-assisted surgery, when compared to open surgery, reduced hospital time, readmissions, and led to better levels of fitness and quality of life; on all counts, this was demonstrated,” said study co-chief investigator John Kelly, a professor at the University College London (UCL).
“An unexpected finding was the striking reduction in blood clots in patients undergoing robotic surgery; this indicates a safe surgery with patients benefiting from far fewer complications, early mobilisation, and a faster return to normal life,” Kelly explained.
Unlike open surgery, which involves a surgeon working directly on a patient and large incisions in the skin and muscle, robot-assisted surgery allows surgeons to remotely guide minimally invasive instruments via a console and three-dimensional (3D) view.
However, it is currently only available in a few hospitals in the United Kingdom.
338 patients with non-metastatic bladder cancer were randomly assigned to one of two groups: 169 had robot-assisted bladder removal with intracorporeal reconstruction (process of taking section of bowel to make new bladder) and 169 had open radical cystectomy.
According to the researchers, the robot-assisted group stayed in the hospital for eight days on average, compared to ten days for the open surgery group, a 20% reduction.
Readmission to the hospital within 90 days of surgery was also significantly reduced: 21% for the robot-assisted group vs 32% for the open group, they reported.
A total of 20 secondary outcomes were evaluated 90 days, six months, and twelve months after surgery. These factors included the prevalence of blood clots, wound complications, quality of life, disability, stamina, activity levels, and survival.
According to the researchers, robot-assisted surgery improved or was nearly equal to open surgery in all secondary outcomes.
Both robot-assisted and open surgery are equally effective in terms of cancer recurrence and length of survival, according to this and previous research.