Comparative analysis of surgical inflammatory response with C-reactive protein post robotic versus laparoscopic elective colorectal resection for colorectal tumour

Objective Robotic colorectal surgery (RCS) provides a stable, magnified three-dimensional visual field and enhanced ergonomics enabling precise dissection and tremor suppression. We postulate that this technique is associated with less tissue trauma and improved postoperative outcomes than laparoscopic colorectal surgery (LCS). This study aimed to explore the inflammatory response following RCS by measuring postoperative C-reactive protein (CRP) levels and compare them with LCS data reported in the literature. Methods This single centre retrospective study included consecutive elective robotic colon and rectum resections via the da Vinci® Xi platform for benign and malignant colorectal tumours, performed by a single surgeon between January 2017 and December 2023 at the Sydney Adventist Hospital, Sydney. CRP values were measured on postoperative days (PODs) 3 and 5. A narrative review of the literature was performed via EMBASE, MEDLINE via PubMed and Google Scholar from inception to December 2024 for comparative CRP values following LCS. Descriptive statistical comparisons were performed between the RCS and LCS. Results One hundred ninety-three patients were identified in the RCS cohort. The median age was 73 y (range: 62–83 y). Most colectomies were performed for adenocarcinoma (90.2%), with right hemicolectomy being the most common type of procedure (49.3%). The median CRP levels on PODs 3 and 5 were 83.10 mg/L (IQR: 49.80–124.12 mg/L) and 26.20 mg/L (IQR: 17.70–80.00 mg/L), respectively. The reported CRP after LCS was heterogeneous, with mean POD 3 values ranging from 69 mg/L to 99.5 mg/L, and mean POD 4–5 values ranging from 62.4 mg/L to 72.85 mg/L. Conclusions There were similar, if not lower, POD 3 and 5 CRP values, suggesting that RCS was probably non-inferior to LCS regarding postoperative tissue trauma. In particular, there appeared to be a quicker recovery of the inflammatory response with RCS.