A comparative meta-analysis and systematic review of robot-assisted versus laparoscopic hemihepatectomy

Hepatectomy is a common surgical procedure in hepatobiliary surgery. Sufficient studies have proved that laparoscopic hemihepatectomy is not different from open surgery in terms of safety and reliability. However, there is a lack of high-level evidence on the advantages and disadvantages of laparoscopic and robot-assisted hemihepatectomy. Our aim is to compare the two surgical procedures through meta-analysis. After searching databases such as PubMed, Web of Science, and Embase, 8 articles that met the criteria were included. Then, the extracted data were analyzed using Review Manager 5.3. A sensitivity analysis was performed to ensure the reliability of the results. This meta-analysis encompassed 1113 patients, of whom 579 were in the robot group and 534 in the laparoscopic group. The intraoperative blood loss in the robot group was less than that in the laparoscopic group, and the conversion rate to open surgery in the robot group was lower than that in the laparoscopic group. No differences were observed in operation time, hospital stay, complications, and intraoperative blood transfusion rate. The robotic approach can be safely employed in hemihepatectomy just as the laparoscopic approach can, and it has advantages in terms of intraoperative blood loss and the conversion rate to open surgery.