Troisi R.I.,Ghent University |
Patriti A.,ASL3 Umbria San Matteo degli Infermi Hospital |
Montalti R.,Ghent University |
Casciola L.,ASL3 Umbria San Matteo degli Infermi Hospital
International Journal of Medical Robotics and Computer Assisted Surgery | Year: 2013
Background: Laparoscopic liver resection (LAPR) is safe and feasible with a better postoperative course as compared to open resections. Robot-assisted liver surgery (ROBR) is a potential alternative to LAPR. In this study we compare outcomes between ROBR and LAPR. Methods: Forty patients underwent ROBR and 223 LAPR for various indications. The surgical outcomes of two institutions, each with a specific advanced experience in laparoscopic and robotic surgery, were reviewed. Results: The major hepatectomy rate was significantly higher in LAPR (16.6% vs 0%, p=0.011) while a parenchyma-preserving approach was favoured in ROBR (55% vs 34.1%, p=0.019). More nodules were resected in the ROBR group (1.97±1.4 vs 1.57±1.1, p=0.04). Overall conversion rate was 8/40 (20%) in the ROBR and 17/223 (7.6%) in the LAPR group (p=0.034). Mean blood loss was 330±303ml and 174±133ml for the ROBR and LAPR groups, respectively (p=0.001) Conclusions: Despite higher conversion rates and blood loss, robot-assisted surgery may allow the resection of more liver lesions, especially those located in the postero-superior segments, facilitating parenchyma-saving surgery with a comparable complication rate with respect to LAPR. © 2013 John Wiley & Sons, Ltd.