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Robotic-assisted right colectomy. Official expert recommendations delivered under the aegis of the French Association of Surgery (AFC)
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International audience. Twenty-seven experts under the aegis of the French Association of Surgery (AFC)offer this reference system with formalized recommendations concerning the performance ofright colectomy by robotic approach (RRC). For RRC, experts suggest patient installation inthe so-called ‘‘classic’’ or ‘‘suprapubic’’ setup. For patients undergoing right colectomy for abenign pathology or cancer, RRC provides no significant benefit in terms of intra-operative bloodloss, intra-operative complications or conversion rate to laparotomy compared to laparoscopy.At the same time, RRC is associated with significantly longer operating times. Data from theliterature are insufficient to define whether the robot facilitates the performance of an intra-abdominal anastomosis, but the robotic approach is more frequently associated with an intra-abdominal anastomosis than the laparoscopic approach. Experts also suggest that RRC offers abenefit in terms of post-operative morbidity compared to right colectomy by laparotomy. Nobenefit is retained in terms of mortality, duration of hospital stay, histological results, overallsurvival or disease-free survival in RRC performed for cancer. In addition, RRC should not beperformed based on the cost/benefit ratio, since RRC is associated with significantly highercosts than laparoscopy and laparotomy. Future research in the field of RRC should considerthe evaluation of patient-targeted parameters such as pain or quality of life and the technicaladvantages of the robot for complex procedural steps, as well as surgical and oncological results.
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