Document Type

Conference Proceeding

Publication Date

10-7-2025

Abstract

Introduction: Surgical robotics have become more accessible in rural healthcare centers across Michigan, driving a growing demand for clinical outcomes data in these areas. National studies have shown that robotic colectomies reduce postoperative complications compared to open procedures, but data specific to rural settings remain limited. This study aims to compare postoperative complications following open, laparoscopic, and robotic right colectomies in rural Michigan.
Methods: The Healthcare Cost and Utilization Project (HCUP) Michigan inpatient database (2016-2018) was used to analyze postoperative complications after right colectomies in urban and rural hospitals. Complications analyzed included: prolonged ileus, pneumonia, surgical site infection, septicemia, hemorrhage/hematoma, urinary tract infection, death prior to discharge, and length of stay (5+ days). ICD-10 procedure codes identified patients undergoing open, laparoscopic, or robotic right colectomies. Logistic regression models calculated the relative risk of complications for laparoscopic vs. open and robotic vs. open procedures, with 95% confidence intervals.
Results: Minimally invasive approaches in rural areas significantly reduced the studied postoperative complications compared to open procedures. Among rural patients, robotic right colectomies had the lowest complication rates. However, robotic right colectomies performed in urban hospitals were associated with even greater reductions in complications compared to rural settings.
Conclusion: Consistent with national trends, minimally invasive right colectomy approaches significantly reduce postoperative complications in rural Michigan. However, the benefits of robotic right colectomies appear greater in urban settings, suggesting potential disparities in surgical outcomes. Further research is needed to examine the impact of hospital resources, surgeon experience, and patient selection on these differences.

Comments

ACS (American College of Surgeons) Clinical Congress, October 4-7, 2025, Chicago, IL

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