Robotic versus standard open pancreatectomy: a propensity score-matched analysis comparison

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Robotic pancreatectomy is gaining interest, but evidence comparing it to open surgery is limited.
• Assessing the safety and efficacy of robotic approaches is crucial for surgical decision-making.

Purpose of the Study:

• To compare the safety and efficacy of robotic pancreatectomy versus the conventional open surgical approach.
• To evaluate outcomes across different types of pancreatectomy: pancreaticoduodenectomy (PD), pancreatic enucleation (PE), and distal pancreatectomy (DP).

Main Methods:

• A propensity score-matched (1:1) analysis was conducted.
• Compared 17 robotic PD, 12 robotic PE, and 28 robotic DP with their open counterparts.
• Key outcomes included operative time, blood loss, hospital stay, and morbidity.

Main Results:

• Robotic PD had longer operative times but significantly less blood loss (190 vs. 394 ml).
• Robotic PE demonstrated a shorter hospital stay (8.4 vs. 12.8 days).
• Robotic DP showed less blood loss (175 vs. 375 ml), reduced severe morbidity (7.14% vs. 17.9%), and shorter hospital stay (8.9 vs. 15.1 days).
• Overall conversion rate to open surgery was 7%.

Conclusions:

• Robotic pancreatectomy is a safe and effective alternative to open surgery.
• Specific benefits include reduced blood loss in PD and DP, and shorter hospital stays in PE and DP.
• Robotic surgery also leads to decreased severe morbidity in DP procedures.