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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.
Background:
Hepatic artery infusion pump (HAIP) placement is associated with improved outcomes in the treatment of colorectal liver metastases (CRLM). In this study, we examined outcomes following robotic HAIP placement, which were compared with open and laparoscopic placement.
Methods:
A retrospective review of HAIP placements by 2 surgeons at a single institution was carried out. All statistical tests were 2-sided and p < 0.05 was considered significant.
Results:
There were a total of 53 open HAIP cases, 21 laparoscopic cases, and 24 robotic cases. Robotic HAIP placement was associated with a significantly lower conversion rate to open operation than laparoscopic pump placement (17 vs. 67%; p = 0.0009). When cases with concomitant resections were excluded, there was a trend towards shorter median length of hospital stay with robotic pump placement compared with open and laparoscopic placement (4 vs. 5 vs. 5 days, respectively; p = 0.09). Complication rates were equivalent among the 3 groups when concomitant resections were excluded.
Conclusion:
Robotic HAIP placement is a safe minimally-invasive procedure that is associated with a significantly lower conversion rate to open operation compared with laparoscopic placement and a trend towards shorter hospitalization compared with open placement.
