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Robot-assisted versus laparoscopic minor hepatectomy: A systematic review and meta-analysis
Ji-Ming Wang1, Jiang-Fa Li, Guan-Dou Yuan
1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Medicine
|April 28, 2021
Summary
Robot-assisted minor hepatectomy (RMH) and laparoscopic minor hepatectomy (LMH) show similar safety and effectiveness for liver lesion removal. RMH involves longer operative times and higher costs, but clinical outcomes are comparable between the two minimally invasive surgical approaches.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Hepatobiliary Surgery
Background:
- Robot-assisted surgery and laparoscopic surgery are leading minimally invasive techniques for liver lesion removal.
- Minor hepatectomy is a frequently performed surgical procedure for liver conditions.
Purpose of the Study:
- To compare the advantages and disadvantages of robot-assisted minor hepatectomy (RMH) versus laparoscopic minor hepatectomy (LMH).
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, and the Cochrane Library up to February 2020.
- Comparative studies on RMH versus LMH were identified and analyzed using meta-analysis techniques.
- Odds ratios and mean differences with 95% confidence intervals were calculated using fixed- or random-effects models.
Main Results:
- The meta-analysis included 12 studies with 751 patients (297 RMH, 454 LMH).
- No significant differences were found in intraoperative blood loss, transfusion rates, hospital stay, conversion rates, R0 resection, complications, or mortality.
- RMH was associated with longer operative times and higher costs compared to LMH, with no differences in overall or disease-free survival.
Conclusions:
- Robot-assisted minor hepatectomy (RMH) demonstrates comparable safety and effectiveness to laparoscopic minor hepatectomy (LMH).
- Despite longer operative times and increased costs, RMH offers similar clinical outcomes.
- Prospective randomized controlled trials are recommended to establish stronger clinical consensus.
