Hyung Joon Han1,2, Chang Moo Kang3,4. 1. Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea. 2. Division of Hepatobiliopancreas and Transplant Surgery, Korea University Ansan Hospital, 123, Jeokguem-ro, Ansan-si, Gyeonggi-do, 15355, Republic of Korea. 3. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. cmkang@yuhs.ac. 4. Yonsei Pancreatobiliary Cancer Center, Severance Hospital, Seoul, Republic of Korea. cmkang@yuhs.ac.
Abstract
BACKGROUND: Minimally invasive surgery appears to be developing in multiple directions, including single-port laparoscopic (SPL), single-port robotic, reduced port laparoscopic, or single-site plus one-port robotic approach. The aim of study was to compare the short-term perioperative variables and outcomes of patients undergoing reduced port minimally invasive distal pancreatectomy (DP) via the SPL, or robotic single-site plus one-port (RSS + 1) approach. METHODS: The medical records of 35 patients were retrospectively reviewed, who underwent SPL-DP (n = 22) or RSS + 1 DP (n = 13) at Korea University Ansan Hospital and Yonsei University Severance Hospital. RESULTS: The mean operation time in SPL group was significantly higher than that of RSS + 1 group (281 vs 192, p = .001). The mean blood loss in SPL was significantly larger than that of RSS + 1 group (163 vs 12, p = .002). The mean length of free resection margin in SPL group was significantly longer than that of RSS + 1 group (2.1 vs 0.4 cm, p = .001). Spleen was significantly preserved in SPL group (54.5 vs 7.7%, p = .001). All RSS + 1 cases had tumors located near spleen hilum (p < .001). SPL approach had significantly grade IIIa complications (p = .014). Moreover, the mean hospital stay in SPL group was significantly longer than that of RSS + 1 group (14.4 vs 7.4 days, p = .004). Postoperative pancreatic fistula (POPF) was significantly observed in longer operation time (p = .043) and smaller tumor size (p = .037) in the univariate analysis. Higher BMI was significantly important factor for prolonged operation time (p = .034) in the multivariate analysis. Prolonged hospital stay was related to spleen preservation (p = .014) in the multivariate analysis. CONCLUSIONS: Both SPL and RSS + 1 are technically feasible and safe. RSS + 1-DP is superior to SPL-DP in terms of operation time, blood loss, severe complications, and hospital stay. SPL-DP shows advantages in terms of single wound site, less trocar usage, higher rate of spleen preservation, and wider range of operative field.
BACKGROUND: Minimally invasive surgery appears to be developing in multiple directions, including single-port laparoscopic (SPL), single-port robotic, reduced port laparoscopic, or single-site plus one-port robotic approach. The aim of study was to compare the short-term perioperative variables and outcomes of patients undergoing reduced port minimally invasive distal pancreatectomy (DP) via the SPL, or robotic single-site plus one-port (RSS + 1) approach. METHODS: The medical records of 35 patients were retrospectively reviewed, who underwent SPL-DP (n = 22) or RSS + 1 DP (n = 13) at Korea University Ansan Hospital and Yonsei University Severance Hospital. RESULTS: The mean operation time in SPL group was significantly higher than that of RSS + 1 group (281 vs 192, p = .001). The mean blood loss in SPL was significantly larger than that of RSS + 1 group (163 vs 12, p = .002). The mean length of free resection margin in SPL group was significantly longer than that of RSS + 1 group (2.1 vs 0.4 cm, p = .001). Spleen was significantly preserved in SPL group (54.5 vs 7.7%, p = .001). All RSS + 1 cases had tumors located near spleen hilum (p < .001). SPL approach had significantly grade IIIa complications (p = .014). Moreover, the mean hospital stay in SPL group was significantly longer than that of RSS + 1 group (14.4 vs 7.4 days, p = .004). Postoperative pancreatic fistula (POPF) was significantly observed in longer operation time (p = .043) and smaller tumor size (p = .037) in the univariate analysis. Higher BMI was significantly important factor for prolonged operation time (p = .034) in the multivariate analysis. Prolonged hospital stay was related to spleen preservation (p = .014) in the multivariate analysis. CONCLUSIONS: Both SPL and RSS + 1 are technically feasible and safe. RSS + 1-DP is superior to SPL-DP in terms of operation time, blood loss, severe complications, and hospital stay. SPL-DP shows advantages in terms of single wound site, less trocar usage, higher rate of spleen preservation, and wider range of operative field.
Entities:
Keywords:
Distal pancreatectomy; Laparoscopic; Robotic; Single port
Authors: Al-Warith Al Hashmi; Guillaume Pineton de Chambrun; Regis Souche; Martin Bertrand; Vito De Blasi; Eric Jacques; Santiago Azagra; Jean Michel Fabre; Frédéric Borie; Michel Prudhomme; Nicolas Nagot; Francis Navarro; Fabrizio Panaro Journal: Surg Endosc Date: 2018-06-25 Impact factor: 4.584
Authors: Byung Mo Kang; Hyung Jin Kim; Bong-Hyeon Kye; Sang Chul Lee; Kil Yeon Lee; Sun Jin Park; Suk-Hwan Lee; Sang Woo Lim; Yoon Suk Lee; Ji Hoon Kim; Jinkwon Lee; Min Ki Kim; Jun-Gi Kim Journal: Surg Endosc Date: 2017-09-15 Impact factor: 4.584
Authors: Mustapha Daouadi; Amer H Zureikat; Mazen S Zenati; Haroon Choudry; Alan Tsung; David L Bartlett; Steven J Hughes; Ken K Lee; A James Moser; Herbert J Zeh Journal: Ann Surg Date: 2013-01 Impact factor: 12.969