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Robotic hepatic arterial infusion pump placement.

Motaz Qadan1, Michael I D'Angelica2, Nancy E Kemeny3

  • 1Department of Surgery, Massachusetts General Hospital, USA.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
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PubMed
Summary

Robotic hepatic artery infusion pump (HAIP) placement for colorectal liver metastases (CRLM) is safe. This minimally invasive approach shows a lower conversion rate than laparoscopic surgery and a trend toward shorter hospital stays.

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Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Gastrointestinal Oncology

Background:

  • Hepatic artery infusion pump (HAIP) placement is a key treatment for colorectal liver metastases (CRLM).
  • Robotic-assisted surgery offers potential advantages in minimally invasive procedures.

Purpose of the Study:

  • To compare outcomes of robotic HAIP placement with traditional open and laparoscopic methods.
  • To evaluate the safety and efficacy of robotic HAIP placement for CRLM.

Main Methods:

  • Retrospective review of 98 HAIP placements (53 open, 21 laparoscopic, 24 robotic) by two surgeons.
  • Statistical analysis comparing conversion rates, length of hospital stay, and complication rates.

Main Results:

  • Robotic HAIP placement had a significantly lower conversion rate to open surgery than laparoscopic (17% vs. 67%, p=0.0009).
  • Excluding concomitant resections, robotic placement showed a trend toward shorter hospital stays (4 days vs. 5 days for open/laparoscopic, p=0.09).
  • Complication rates were similar across all groups when concomitant resections were excluded.

Conclusions:

  • Robotic HAIP placement is a safe and effective minimally invasive option for CRLM treatment.
  • It offers a significant reduction in conversion rates compared to laparoscopic approaches.
  • Robotic surgery shows a promising trend towards reduced hospitalization duration.