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Robotic versus open total pancreatectomy: a systematic review and meta-analysis
Mohamed Ali Chaouch1, Amine Gouader2, Alessandro Mazzotta3
1Department of Visceral and Digestive Surgery, Monastir University Hospital, University of Monastir, Monastir, Tunisia. docmedalichaouch@gmail.com.
Journal of Robotic Surgery
|March 15, 2023
Summary
Robotic total pancreatectomy (RTP) shows similar safety and efficacy to open total pancreatectomy (OTP). RTP offers a quicker recovery, enabling earlier diet initiation and patient mobility.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Limited data exist on postoperative outcomes for robotic total pancreatectomy (RTP).
- Comparison with open total pancreatectomy (OTP) is crucial for understanding RTP's role.
- Assessing safety and efficacy of RTP is essential for clinical adoption.
Approach:
- Systematic review and meta-analysis adhering to PRISMA 2020 and AMSTAR 2 guidelines.
- Inclusion of four controlled clinical trials with 156 patients (65 RTP, 91 OTP) up to August 10, 2022.
- Comprehensive comparison of postoperative outcomes between RTP and OTP.
Key Points:
- No significant differences observed in mortality, severe complications, morbidity, bleeding, biliary leak, delayed gastric emptying, reoperation, operative time, length of stay, lymph node yield, or margin positivity.
- Robotic total pancreatectomy (RTP) demonstrated faster initiation of first liquid diet, first oral diet, and earlier mobilization (out of bed).
- RTP is feasible and safe in selected patients, facilitating a quicker recovery.
Conclusions:
- Robotic total pancreatectomy (RTP) is a safe and feasible alternative to open total pancreatectomy (OTP) in select patients.
- RTP offers advantages in early recovery, including faster return to oral intake and improved mobility.
- Preoperative consideration for conversion to laparotomy is advised in cases of major vessel invasion during robotic procedures.
