Robot assistance in liver surgery: a real advantage over a fully laparoscopic approach? Results of a comparative bi‐institutional analysis. Issue 2 (21st March 2013)

• Record Type: Journal Article
• Authors: Troisi, Roberto I.; Patriti, Alberto; Montalti, Roberto; Casciola, Luciano
• Is Part Of: International journal of medical robotics and computer assisted surgery. Volume 9:Issue 2(2013)
• Page Start: 160
• Page End: 166
• Publication Date: 2013-03-21
• Subjects: Robotics in medicine -- Periodicals; Surgery -- Technological innovations -- Periodicals; Imaging systems in medicine -- Periodicals; 617.90285
• DOI: 10.1002/rcs.1495
• Languages: English
• ISSNs: 1478-5951

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="rcs1495-sec-0001" sec-type="section"> <title>Background</title> <p>Laparoscopic liver resection (LAPR) is safe and feasible with a better postoperative course as compared to open resections. Robot‐assisted liver surgery (ROBR) is a potential alternative to LAPR. In this study we compare outcomes between ROBR and LAPR.</p> </sec> <sec id="rcs1495-sec-0002" sec-type="section"> <title>Methods</title> <p>Forty patients underwent ROBR and 223 LAPR for various indications. The surgical outcomes of two institutions, each with a specific advanced experience in laparoscopic and robotic surgery, were reviewed.</p> </sec> <sec id="rcs1495-sec-0003" sec-type="section"> <title>Results</title> <p>The major hepatectomy rate was significantly higher in LAPR (16.6% vs 0%, <italic>p =</italic> 0.011) while a parenchyma‐preserving approach was favoured in ROBR (55% vs 34.1%, <italic>p =</italic> 0.019). More nodules were resected in the ROBR group (1.97 ± 1.4 vs 1.57 ± 1.1, <italic>p =</italic> 0.04). Overall conversion rate was 8/40 (20%) in the ROBR and 17/223 (7.6%) in the LAPR group (<italic>p =</italic> 0.034). Mean blood loss was 330 ± 303 ml and 174 ± 133 ml for the ROBR and LAPR groups, respectively (<italic>p =</italic> 0.001)</p> </sec> <sec id="rcs1495-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Despite higher conversion rates and blood loss, robot‐assisted surgery may allow the resection of more liver lesions, especially those located in the postero‐superior segments, facilitating parenchyma‐saving surgery with a comparable complication rate with respect to LAPR. Copyright © 2013 John Wiley & Sons, Ltd.</p> </sec> </abstract>