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Laparoscopic robot-assisted versus open total pancreatectomy: a case-matched study
Ugo Boggi1, Simona Palladino, Gabriele Massimetti
1Division of General and Transplant Surgery, Pisa University Hospital Pisa, Via Paradisa 2, 56124, Pisa, Italy, u.boggi@med.unipi.it.
Surgical Endoscopy
|August 28, 2014
Summary
Laparoscopic robot-assisted total pancreatectomy (LRATP) shows feasibility and reduced blood loss compared to open surgery. While operative time is longer, LRATP offers comparable complication rates and improved lymph node examination in selected patients.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Robotic assistance may offer benefits in complex pancreatic resections like total pancreatectomy.
- Total pancreatectomy avoids pancreatic fistula risks and presents unique dissection and reconstruction challenges.
- Robotic assistance could enhance outcomes for pancreatic resections where dexterity is crucial.
Purpose of the Study:
- To compare the outcomes of laparoscopic robot-assisted total pancreatectomy (LRATP) with open total pancreatectomy.
- To evaluate the feasibility and safety of LRATP in selected patients.
- To assess the impact of robotic assistance on operative time, blood loss, and complications.
Main Methods:
- A case-matched comparison of 11 LRATP procedures and 11 open total pancreatectomies.
- All surgeries performed by a single surgeon during the same time period.
- Data collected included operative details, blood loss, complications, and oncologic outcomes.
Main Results:
- LRATP demonstrated significantly decreased mean blood loss (220 vs. 705 mL) compared to open surgery.
- Mean operative time was longer for LRATP (600 vs. 469 min).
- Post-operative complication rates were similar, with most LRATP complications being mild; oncologic outcomes (margin status, lymph nodes) were favorable.
Conclusions:
- Laparoscopic robot-assisted total pancreatectomy is feasible in selected patients.
- Further experience is required to fully establish the benefits and optimal application of LRATP.
- Robotic assistance may enhance lymph node dissection and reduce blood loss in total pancreatectomy.
