Comparative Study of the Initial Experience in Performing Robotic and Laparoscopic Right Hepatectomy with Technical Description of the Robotic Technique

Dig Surg. 2019;36(3):241-250. doi: 10.1159/000487686. Epub 2018 Mar 14.

Abstract

Background: Despite potential benefits of robotic liver surgery, it is still considered a "development in progress" technique.

Methods: The outcomes of 14 patients undergoing robotic right hepatectomy were analyzed and compared with the results of 20 laparoscopic right hepatectomies consecutively performed by the same young surgeon.

Results: The overall mean operative time was less in robotic arm (425 ± 139 vs. 565.18 ± 183.73, p = 0.022) and the estimated blood loss was similar (335.15 ± 139.8 vs. 423.95 ± 205.15, p = 0.17); no blood transfusion was required. Two patients in robotic group and 5 in laparoscopic group (p = 0.454) underwent conversion to open surgery; the overall morbidity was 21.4 and 15% in studied arms, respectively (p = 0.634). Pathology reports showed a mean surgical margin of 26.02 ± 3.9 in robotic arm, 28.76 ± 4.6 for laparoscopic, (p = 0.079) and we achieved a R0 resection rate of 91.66 and 85%, respectively. Reoperation and 90-days mortality rate were both null in robotic arm. One patient in laparoscopic group was reoperated due to postoperative hemorrhage. One-year overall and disease free-survival rate were 92.3 and 84.6%, respectively in robotic arm and 90 and 85% in laparoscopic arm.

Conclusions: Robotic right hepatectomy is a safe and feasible technique providing promising short-term outcomes and oncological results also in the initial phase of learning curve.

Keywords: Right Hepatectomy; Robotic surgery; Surgical technique.

Publication types

  • Comparative Study

MeSH terms

  • Clinical Competence
  • Feasibility Studies
  • Hepatectomy / methods*
  • Hepatectomy / standards
  • Humans
  • Laparoscopy / methods*
  • Laparoscopy / standards
  • Learning Curve*
  • Liver Neoplasms / surgery*
  • Retrospective Studies
  • Robotic Surgical Procedures / methods*
  • Robotic Surgical Procedures / standards