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Robotic versus conventional laparoscopic liver resections: A systematic review and meta-analysis
Sivesh Kathir Kamarajah1,2, James Bundred3, Derek Manas2
1Department of Hepatobiliary, Pancreatic and Transplant Surgery, Department of Surgery, The Freeman Hospital, Tyne and Wear, Newcastle upon Tyne NE7 7DN, UK.
Summary
Robotic liver resection shows less blood loss and lower readmission rates compared to laparoscopic surgery. However, operating times are longer, and more research is needed to confirm these findings.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Robotic surgery offers theoretical advantages like enhanced dexterity and visualization over conventional laparoscopic surgery.
- This review focuses on robotic versus laparoscopic liver resections.
Purpose of the Study:
- To systematically review and meta-analyze the advantages of robotic over laparoscopic liver resection.
- To compare intraoperative, oncological, and postoperative outcomes.
Main Methods:
- Systematic literature search for comparative studies of robotic and laparoscopic liver resection.
- Meta-analysis of outcomes including operative time, blood loss, complications, and mortality.
- Random effects model used for analysis.
Main Results:
- 26 studies with 2630 patients (950 robotic, 1680 laparoscopic) were analyzed.
- Robotic liver resection had significantly less blood loss but longer operative time.
- No significant differences in conversion, transfusion, overall complications, or length of stay; however, robotic surgery showed lower readmission rates.
Conclusions:
- Robotic liver resection presents some advantages over laparoscopic surgery, though outcomes are largely equivalent.
- Current evidence is limited to cohort studies.
- A high-quality randomized trial is necessary to definitively compare both techniques.
