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Level 2a evidence comparing robotic versus laparoscopic left lateral hepatic sectionectomy: a meta-analysis
Shahin Hajibandeh1, Shahab Hajibandeh2, Alexios Dosis3
1Hepatobiliary and Pancreatic Surgery and Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, UK. shahin_hajibandeh@yahoo.com.
Langenbeck'S Archives of Surgery
|October 26, 2021
Summary
Robotic left lateral hepatic sectionectomy (LLS) takes longer and costs more than laparoscopic LLS. However, both surgical methods show similar patient outcomes regarding complications and recovery.
Area of Science:
- Minimally Invasive Surgery
- Hepatobiliary Surgery
- Surgical Technology
Background:
- Left lateral hepatic sectionectomy (LLS) is a complex liver procedure.
- Robotic and laparoscopic approaches offer distinct advantages in minimally invasive surgery.
- Comparative outcome data is crucial for surgical decision-making.
Purpose of the Study:
- To compare the perioperative outcomes of robotic versus laparoscopic left lateral hepatic sectionectomy (LLS).
- To evaluate key metrics including complications, procedure time, blood loss, and cost-effectiveness.
Main Methods:
- A systematic literature review and meta-analysis of comparative observational studies.
- Searches conducted across PubMed, Web of Science, and EMBASE databases.
- Outcome measures included postoperative complications (minor and major), mortality, blood loss, conversion rates, procedure time, hospital stay, cost, and R1 resection.
Main Results:
- Seven studies involving 319 patients (150 robotic, 169 laparoscopic) were analyzed.
- Robotic LLS demonstrated significantly longer procedure times (29.40 min) and higher costs ($4170).
- No significant differences were observed in overall morbidity, complication severity, mortality, blood loss, conversion rates, hospital stay, or R1 resection rates.
Conclusions:
- Robotic LLS is associated with increased procedure time and cost compared to the laparoscopic approach.
- Perioperative outcomes are comparable between robotic and laparoscopic LLS.
- Further randomized controlled trials are needed to assess long-term oncological and surgeon-centered outcomes.
