ROBOTIC-ASSISTED SURGERY INDICATIONS AND OUTCOMES: PERSPECTIVES FROM GENERAL SURGERY

Abstract

Abstract                                                                                                                                                                                                                          
In the realm of general surgery, understanding the nuances in outcomes between procedures for benign and malignant conditions remains a critical area of investigation. This study delved into the perioperative outcomes of 2,757 patients who underwent robotic-assisted general surgery between January 2018 and May 2021. Notably, patients with malignant conditions (n=441) presented with distinct demographic characteristics, including advanced age, higher BMI, and increased medical comorbidities compared to those with benign conditions (n=2,316). Malignant cases exhibited prolonged surgical durations, elevated rates of intraoperative complications, and a heightened likelihood of conversion to laparotomy, alongside extended hospital stays relative to benign cases. Additionally, postoperative complications were more prevalent among malignant cases, culminating in a higher incidence of emergency department visits and readmissions within six weeks post-surgery. Despite adjustments for confounding factors, including age, BMI, and comorbidities, malignancy retained associations with prolonged operative times, diminished rates of same-day discharges, and increased conversions to laparotomy and hospital readmissions. These findings underscore the imperative for surgeons and healthcare stakeholders to meticulously consider the differential outcomes between benign and malignant procedures in general surgery, particularly in the context of evolving reimbursement paradigms towards value-based models.