Carolijn L Nota1,2, Yanghee Woo1, Mustafa Raoof1, Thomas Boerner3, I Quintus Molenaar2, Gi Hong Choi4, T Peter Kingham3, Karen Latorre4, Inne H M Borel Rinkes2, Jeroen Hagendoorn2, Yuman Fong5. 1. Department of Surgery, City of Hope National Medical Center, City of Hope Hospital Duarte, Duarte, CA, USA. 2. Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. 3. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 4. Department of Surgery, Yonsei University Severance Hospital, Seoul, Republic of Korea. 5. Department of Surgery, City of Hope National Medical Center, City of Hope Hospital Duarte, Duarte, CA, USA. yfong@coh.org.
Abstract
BACKGROUND: Minor liver resections of posterosuperior segments (1, 4A, 7, 8) are challenging to perform laparoscopically and are mainly performed using an open approach. We determined the feasibility of robotic resections of posterosuperior segments and compared short-term outcomes with the open approach. METHODS: Data on open and robotic minor (≤ 3 segments) liver resections including the posterosuperior segments, performed between 2009 and 2016, were collected retrospectively from four hospitals. Robotic and open liver resections were compared, before and after propensity score matching. RESULTS: In total, 51 robotic and 145 open resections were included. After matching, 31 robotic resections were compared with 31 open resections. Median hospital stay was 4 days (interquartile range [IQR] 3-7) for the robotic group, versus 8 days (IQR 6-10) for the open group (p < 0.001). Median operative time was 222 min (IQR 164-505) for robotic cases versus 231 min (IQR 190-301) for open cases (p = 0.668). Median estimated blood loss was 200 mL (IQR 100-400) versus 300 mL (IQR 125-750), respectively (p = 0.212). In the robotic group, one patient (3%) had a major complication, versus three patients (10%) in the open group (p = 0.612). Readmissions were similar-10% in the robotic group versus 6% in the open group (p > 0.99). There was no mortality in either group. CONCLUSION: Minor robotic liver resections of the posterosuperior segments are safe and feasible and display a shorter length of stay than open resections in selected patients at expert centers.
BACKGROUND: Minor liver resections of posterosuperior segments (1, 4A, 7, 8) are challenging to perform laparoscopically and are mainly performed using an open approach. We determined the feasibility of robotic resections of posterosuperior segments and compared short-term outcomes with the open approach. METHODS: Data on open and robotic minor (≤ 3 segments) liver resections including the posterosuperior segments, performed between 2009 and 2016, were collected retrospectively from four hospitals. Robotic and open liver resections were compared, before and after propensity score matching. RESULTS: In total, 51 robotic and 145 open resections were included. After matching, 31 robotic resections were compared with 31 open resections. Median hospital stay was 4 days (interquartile range [IQR] 3-7) for the robotic group, versus 8 days (IQR 6-10) for the open group (p < 0.001). Median operative time was 222 min (IQR 164-505) for robotic cases versus 231 min (IQR 190-301) for open cases (p = 0.668). Median estimated blood loss was 200 mL (IQR 100-400) versus 300 mL (IQR 125-750), respectively (p = 0.212). In the robotic group, one patient (3%) had a major complication, versus three patients (10%) in the open group (p = 0.612). Readmissions were similar-10% in the robotic group versus 6% in the open group (p > 0.99). There was no mortality in either group. CONCLUSION: Minor robotic liver resections of the posterosuperior segments are safe and feasible and display a shorter length of stay than open resections in selected patients at expert centers.
Authors: Mateusz Rubinkiewicz; Magdalena Mizera; Piotr Małczak; Natalia Gajewska; Grzegorz Torbicz; Michael Su; Konrad Karcz; Michał Pędziwiatr Journal: Wideochir Inne Tech Maloinwazyjne Date: 2020-04-07 Impact factor: 1.195
Authors: Kevin P Labadie; David J Droullard; Alex W Lois; Sara K Daniel; Kathryn E McNevin; Jaqueline Valdez Gonzalez; Yongwoo D Seo; Kevin M Sullivan; Kyle S Bilodeau; Lindsay K Dickerson; Alan F Utria; John Calhoun; Venu G Pillarisetty; Jonathan G Sham; Raymond S Yeung; James O Park Journal: Surg Endosc Date: 2021-02-19 Impact factor: 4.584