Robotic vs laparoscopic hemihepatectomy: A comparative study from a single center

J Surg Oncol. 2019 Sep;120(4):646-653. doi: 10.1002/jso.25640. Epub 2019 Jul 16.

Abstract

Background: Robotic surgery is increasingly being used in hepatectomy. Previous studies comparing the robotic and laparoscopic minor hepatectomy have been documented, but comparative studies on robotic and laparoscopic hemihepatectomy (LH) involving a large patient cohort are rare. The objective of this study was to compare perioperative outcomes between robotic and LH.

Methods: Data on the demographics, clinicopathologic characteristics, and perioperative outcomes of consecutive patients who underwent robotic or LH in a single center between November 2011 and July 2017 were analyzed.

Results: A total of 92 patients underwent robotic and 48 LH. Multiple linear regression analysis showed no significant difference in perioperative outcomes including operative time, postoperative hospital stay, postoperative complications, and mortality between the groups. Compared to the laparoscopic cohort, the robotic cohort had a significantly less estimated blood loss (120.24 mL; 95% confidence interval, 53.72-186.76) and a significantly lower conversation rate (1.09% vs 10.42%; P = .034). Stratified and interaction analyses demonstrated that disease type had an interaction effect on the association between the operative approach and the estimated blood loss.

Conclusions: Robotic hemihepatectomy was safe and feasible in selected patients. It had similar perioperative outcomes as LH and was better than LH regarding estimated blood loss and open conversion.

Keywords: hemihepatectomy; laparoscopic surgery; minimally invasive surgery; robotic surgery.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Female
  • Follow-Up Studies
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data*
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prognosis
  • Retrospective Studies
  • Robotic Surgical Procedures / methods*