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Short- and intermediate-term clinical outcome comparison between laparoscopic and robotic-assisted median arcuate

Usah Khrucharoen1,2, Yen-Yi Juo1,2, Yijun Chen1

  • 1UCLA Section of Minimally Invasive and Bariatric Surgery, Department of Surgery, David Geffen School of Medicine at University of California, BOX 956904, 72-239 CHS, Los Angeles, CA, 90095, USA.

Journal of Robotic Surgery
|March 23, 2019
PubMed

Insights

Robotic-assisted median arcuate ligament (MAL) release offers similar clinical outcomes to laparoscopic approaches. While operative time is reduced with robotic MAL release, patient recovery and symptom resolution remain comparable between methods.

Area of Science:

  • Minimally Invasive Surgery
  • Gastroenterology
  • Surgical Technology

Background:

  • Laparoscopic median arcuate ligament (MAL) release is a common surgical procedure.
  • Robotic-assisted MAL release is an emerging alternative gaining traction in several institutions.

Purpose of the Study:

  • To compare surgical outcomes between laparoscopic and robotic-assisted MAL release.
  • To evaluate intraoperative, postoperative, and short- to intermediate-term clinical outcomes.

Main Methods:

  • Retrospective study of patients undergoing MAL release (laparoscopic vs. robotic).
  • Data collected from January 1999 to December 2018 in a teaching hospital.
  • Comparison of operative time, conversion rates, complication rates, pain resolution, symptom recurrence, and overall clinical improvement.

Main Results:

  • Median operative time was significantly shorter in the robotic group (106 min) compared to the laparoscopic group (179.5 min).
  • Conversion to open surgery rates were similar (5.6% vs. 6.3%).
  • Postoperative complication rates (16.7% vs. 12.5%), pain resolution (44.4% vs. 37.5%), symptom recurrence (27.8% vs. 37.5%), and clinical improvement (77.8% vs. 87.5%) were not statistically different.

Conclusions:

  • Both laparoscopic and robotic-assisted MAL release provide similar short- and intermediate-term clinical outcomes.
  • Robotic platform incorporation can lead to a shortened operative time for MAL release.
  • The choice of approach may depend on institutional experience and patient factors, with comparable efficacy in symptom management.
Keywords:
Laparoscopic procedureMedian arcuate ligament releaseOutcome comparisonRobotic-assisted procedure

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