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An international multicentre propensity score matched analysis comparing between robotic versus laparoscopic left
Yvette Chong1,2, Mikel Prieto3, Mikel Gastaca3
1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital & National Cancer Centre Singapore, Level 5, 20 College Road, Academia, Singapore, 169856, Singapore.
Surgical Endoscopy
|December 21, 2022
Summary
Robotic left lateral sectionectomy (R-LLS) shows reduced blood loss and fewer conversions to open surgery compared to laparoscopic approaches. These findings suggest potential benefits of robotic surgery for this minimally invasive liver resection procedure.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Technology
Background:
- Left lateral sectionectomy (LLS) is a common minimally invasive liver resection.
- Laparoscopic LLS (L-LLS) is established, but robotic LLS (R-LLS) benefits are debated.
- Comparison between R-LLS and L-LLS is crucial for surgical decision-making.
Purpose of the Study:
- To compare perioperative outcomes of robotic versus laparoscopic left lateral sectionectomy.
- To evaluate the efficacy and safety of R-LLS compared to L-LLS.
- To identify potential advantages of R-LLS in minimally invasive liver surgery.
Main Methods:
- Post hoc analysis of 997 patients from 21 international centers (2006-2020).
- 886 cases (214 R-LLS, 672 L-LLS) analyzed after propensity score matching (1:1 and 1:2).
- Outcomes included operating time, blood loss, open conversion, morbidity, and mortality.
Main Results:
- R-LLS demonstrated significantly lower open conversion rates (0.6% vs. 5%) and median blood loss (50 vs. 100) compared to L-LLS after PSM.
- Pringle maneuver was used more frequently in R-LLS (24.8% vs. 12.5%).
- No significant differences observed in operating time, length of stay, morbidity, or 90-day mortality.
Conclusions:
- Robotic LLS offers comparable perioperative outcomes to laparoscopic LLS.
- R-LLS is associated with significantly reduced blood loss and lower rates of conversion to open surgery.
- Robotic assistance may enhance safety and efficiency in minimally invasive liver resections.
