Martina Sardonini

Background: Right hemicolectomy remains the standard surgical treatment for right colon diseases. This study evaluates robotic versus laparoscopic approaches to determine optimal, minimally invasive strategies, balancing technical efficacy with healthcare economics. Materials and Methods: This retrospective study evaluates robotic versus laparoscopic approaches using data from 46 studies (2003–2025) involving 36,868 patients (6,312 robotic, 30,547 laparoscopic). Primary outcomes assessed were lymph node yield, operative time, and hospital stay; secondary outcomes included blood loss, conversion rates, infections, readmissions, and costs. Results: Concerning robotic surgery, lymph node harvest was higher (MD 1.34 for CME; MD 1.27 for non-CME). Laparoscopy showed shorter operative times (MD 25.73 for CME; MD 42.45 for non-CME). Hospital stays showed no significant difference. Robotics demonstrated lower blood loss in non-CME cases (MD -0.38). Conversion rates favored robotics (1% vs. 10% for CME; 4% vs. 8% for non-CME). No significant differences were found in wound infections or non-CME readmissions, though robotics showed lower CME readmission costs (MD 5.34). There were several study-acknowledged limitations, including surgeon preference bias, protocol variability, learning curves, and evolving techniques over the 22-year period. Cost analyses considered both direct surgical expenses and postoperative care. Conclusions: While robotics offers advantages in oncological resection and procedural stability, laparoscopy maintains efficiency benefits. These findings contribute to ongoing discussions about optimal, minimally invasive approaches for right colon pathologies, balancing technical efficacy with healthcare economics. By comparing surgical techniques, surgeon expertise, patient characteristics, and healthcare costs across multiple institutions, this study seeks to provide meaningful insights for surgical decision-making and further standardization.