Comparison of short-term outcomes of intracorporeal and extracorporeal anastomosis in robotic right colectomy using the da Vinci SP system: a multi-center cohort study

BACKGROUND: Intracorporeal anastomosis (ICA) has shown advantages in laparoscopic right colectomy, but its role in robotic surgery using the da Vinci single-port (SP) system remains unclear. This study compared short-term outcomes of ICA and extracorporeal anastomosis (ECA) in SP robotic right colectomy. METHODS: We retrospectively analyzed 110 patients who underwent SP robotic right colectomy at two tertiary centers between November 2020 and February 2025. Perioperative outcomes and 30-day postoperative complications were compared between the two groups. Pain scores were assessed during the early postoperative period. RESULTS: In a total of 110 patients, ICA was 32 and ECA was 78. Baseline characteristics were comparable between the two groups, although comorbidities such as diabetes mellitus and hypertension were more frequent in the ECA group (both p = 0.032). The overall rate of postoperative complications was similar (12.5 vs. 12.8%, p = 0.963), with no significant differences in individual complications. However, the ICA group experienced earlier recovery with a shorter time to first flatus (median 2.5 vs. 3.0 days, p = 0.017) and hospital stay (median 6.0 vs. 7.0 days, p = 0.024), along with consistently lower pain scores from postoperative day 0 to day 3 (all p < 0.001). CONCLUSION: ICA appears to be a safe and effective technique for SP robotic right colectomy. It provides enhanced recovery outcomes, including reduced pain and a shorter hospital stay, without increasing complications, supporting its adoption in experienced centers.