Outcome, efficiency, and possible productivity gains of minimal access approaches in colorectal surgery: the case of the English National Health Service (NHS)

Project reference number – 0082

Principal investigator - Filippos Papadopoulos

Plain language summary - Laparoscopic (keyhole) surgery was introduced in the 1990s in England and it was quickly used in several surgical specialties (for example, gynaecology and gastroenterology) which had traditionally used open approaches. Open approaches require making big cuts on patients and can lead to a longer, more painful recovery. Laparoscopic approaches require only very small cuts in the skin to be made through which instruments are introduced into the body. Laparoscopic surgery is now the preferred option for many operations. Robotic surgery was introduced later in the NHS (beginning of 2000s) and is a more precise method of keyhole surgery where the surgeon uses a robot to perform the surgery. Robotic surgery has become the preferred option for prostate cancer surgery.

This project will research the use of laparoscopic (keyhole) and robotic approaches in bowel cancer surgery between 2000-2018 in the English National Health Service (NHS) and study any improvements these approaches have had over traditional open surgical approaches. The project will look at whether outcomes for patients (such as death due to the procedure) and hospital efficiency (such as length of hospital stay after surgery) have improved over time. Additionally, the project will look at what effect several factors, such as the type of cancer a patient has, how much experience the surgeon has, and the hospital where the patient gets operated on, has on these outcomes.