Robotic versus laparoscopic distal pancreatectomy: A propensity score-matched study

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Robotic distal pancreatectomy (RDP) is a potential alternative to laparoscopic distal pancreatectomy (LDP).
• Previous studies on RDP vs. LDP have limitations like small sample sizes and selection bias.
• This study evaluates the advantages of the robotic approach in distal pancreatectomy.

Purpose of the Study:

• To compare the perioperative outcomes of robotic distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP).
• To identify specific patient groups or conditions where RDP may offer superior results compared to LDP.

Main Methods:

• A retrospective review of 102 patients undergoing RDP and 102 patients undergoing LDP from January 2011 to December 2015.
• A 1:1 propensity score matched analysis was conducted to compare outcomes between the two groups.

Main Results:

• No significant differences in operative time, blood loss, transfusion rates, overall morbidities, or pancreatic fistula rates between RDP and LDP.
• RDP significantly reduced conversion to laparotomy rates (2.9% vs. 9.8%, P=0.045), particularly for large tumors (0% vs. 22.2%, P=0.042).
• RDP improved spleen preservation (SP) and splenic vessel preservation (SVP) rates in patients with moderate tumors and those without malignancy.
• RDP resulted in a significantly shorter postoperative hospital stay (PHS) (7.67 vs. 8.58 days, P=0.032).

Conclusions:

• Robotic distal pancreatectomy (RDP) is associated with a lower rate of conversion to laparotomy compared to LDP.
• RDP leads to a shorter postoperative hospital stay.
• RDP demonstrates improved spleen and splenic vessel preservation rates in selected patient populations.