Robotic versus laparoscopic hepatectomy: A single-center, propensity score- matched study.

Area of Science:

• Minimally Invasive Surgery
• Hepatobiliary Surgery
• Surgical Oncology

Background:

• Robotic hepatectomy (RH) effectiveness is under investigation, with no definitive superiority established over other surgical approaches.
• Comparative studies are needed to evaluate RH against laparoscopic hepatectomy (LH).

Purpose of the Study:

• To compare robotic hepatectomy (RH) and laparoscopic hepatectomy (LH) in terms of perioperative and oncologic outcomes.
• To assess the safety and feasibility of RH for liver resections.

Main Methods:

• A propensity score-matched (PSM) cohort study comparing RH and LH.
• Included 329 patients undergoing liver resection for benign or malignant lesions between 2014-2020.
• Adjusted for confounding factors including age, sex, BMI, ASA score, IWATE criteria, and Charlson comorbidity index.

Main Results:

• After PSM, 72 patients were in each group (RH and LH).
• RH group had longer operative time (231 vs. 180 min; P=.001) but a significantly lower conversion rate (9.7% vs. 0.0%; P=.013).
• No significant differences were observed in blood loss, hospital stay, ICU admission, mortality, morbidity, or tumor margin status.

Conclusions:

• Robotic hepatectomy (RH) demonstrates a reduced rate of conversion to open surgery compared to laparoscopic hepatectomy (LH).
• RH is a feasible and safe surgical option for liver lesions, despite a longer operative time.
• Comparable oncological results were observed between RH and LH for hepatocellular carcinoma patients.