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Robotic vs. laparoscopic liver surgery: a single-center analysis of 600 consecutive patients in 6 years

BACKGROUND: While laparoscopic liver surgery has become a standard procedure, experience with robotic liver surgery is still limited. The aim of this prospective study was to evaluate safety and feasibility of robotic liver surgery and compare outcomes with conventional laparoscopy. METHODS: We here...

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Autores principales: Schmelzle, Moritz, Feldbrügge, Linda, Ortiz Galindo, Santiago Andres, Moosburner, Simon, Kästner, Anika, Krenzien, Felix, Benzing, Christian, Biebl, Matthias, Öllinger, Robert, Malinka, Thomas, Schöning, Wenzel, Pratschke, Johann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283354/
https://www.ncbi.nlm.nih.gov/pubmed/35641702
http://dx.doi.org/10.1007/s00464-021-08770-x
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author Schmelzle, Moritz
Feldbrügge, Linda
Ortiz Galindo, Santiago Andres
Moosburner, Simon
Kästner, Anika
Krenzien, Felix
Benzing, Christian
Biebl, Matthias
Öllinger, Robert
Malinka, Thomas
Schöning, Wenzel
Pratschke, Johann
author_facet Schmelzle, Moritz
Feldbrügge, Linda
Ortiz Galindo, Santiago Andres
Moosburner, Simon
Kästner, Anika
Krenzien, Felix
Benzing, Christian
Biebl, Matthias
Öllinger, Robert
Malinka, Thomas
Schöning, Wenzel
Pratschke, Johann
author_sort Schmelzle, Moritz
collection PubMed
description BACKGROUND: While laparoscopic liver surgery has become a standard procedure, experience with robotic liver surgery is still limited. The aim of this prospective study was to evaluate safety and feasibility of robotic liver surgery and compare outcomes with conventional laparoscopy. METHODS: We here report the results of a single-center, prospective, post-marketing observational study (DRKS00017229) investigating the safety and feasibility of robotic liver surgery. Baseline characteristics, surgical complexity (using the IWATE score), and postoperative outcomes were then compared to laparoscopic liver resections performed at our center between January 2015 and December 2020. A propensity score-based matching (PSM) was applied to control for selection bias. RESULTS: One hundred twenty nine robotic liver resections were performed using the da Vinci Xi surgical system (Intuitive) in this prospective study and were compared to 471 consecutive laparoscopic liver resections. After PSM, both groups comprised 129 cases with similar baseline characteristics and surgical complexity. There were no significant differences in intraoperative variables, such as need for red blood cell transfusion, duration of surgery, or conversion to open surgery. Postoperative complications were comparable after robotic and laparoscopic surgery (Clavien–Dindo ≥ 3a: 23% vs. 19%, p = 0.625); however, there were more bile leakages grade B–C in the robotic group (17% vs. 7%, p = 0.006). Length of stay and oncological short-term outcomes were comparable. CONCLUSIONS: We propose robotic liver resection as a safe and feasible alternative to established laparoscopic techniques. The object of future studies must be to define interventions where robotic techniques are superior to conventional laparoscopy.
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spelling pubmed-92833542022-07-16 Robotic vs. laparoscopic liver surgery: a single-center analysis of 600 consecutive patients in 6 years Schmelzle, Moritz Feldbrügge, Linda Ortiz Galindo, Santiago Andres Moosburner, Simon Kästner, Anika Krenzien, Felix Benzing, Christian Biebl, Matthias Öllinger, Robert Malinka, Thomas Schöning, Wenzel Pratschke, Johann Surg Endosc Article BACKGROUND: While laparoscopic liver surgery has become a standard procedure, experience with robotic liver surgery is still limited. The aim of this prospective study was to evaluate safety and feasibility of robotic liver surgery and compare outcomes with conventional laparoscopy. METHODS: We here report the results of a single-center, prospective, post-marketing observational study (DRKS00017229) investigating the safety and feasibility of robotic liver surgery. Baseline characteristics, surgical complexity (using the IWATE score), and postoperative outcomes were then compared to laparoscopic liver resections performed at our center between January 2015 and December 2020. A propensity score-based matching (PSM) was applied to control for selection bias. RESULTS: One hundred twenty nine robotic liver resections were performed using the da Vinci Xi surgical system (Intuitive) in this prospective study and were compared to 471 consecutive laparoscopic liver resections. After PSM, both groups comprised 129 cases with similar baseline characteristics and surgical complexity. There were no significant differences in intraoperative variables, such as need for red blood cell transfusion, duration of surgery, or conversion to open surgery. Postoperative complications were comparable after robotic and laparoscopic surgery (Clavien–Dindo ≥ 3a: 23% vs. 19%, p = 0.625); however, there were more bile leakages grade B–C in the robotic group (17% vs. 7%, p = 0.006). Length of stay and oncological short-term outcomes were comparable. CONCLUSIONS: We propose robotic liver resection as a safe and feasible alternative to established laparoscopic techniques. The object of future studies must be to define interventions where robotic techniques are superior to conventional laparoscopy. Springer US 2022-05-31 2022 /pmc/articles/PMC9283354/ /pubmed/35641702 http://dx.doi.org/10.1007/s00464-021-08770-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Schmelzle, Moritz
Feldbrügge, Linda
Ortiz Galindo, Santiago Andres
Moosburner, Simon
Kästner, Anika
Krenzien, Felix
Benzing, Christian
Biebl, Matthias
Öllinger, Robert
Malinka, Thomas
Schöning, Wenzel
Pratschke, Johann
Robotic vs. laparoscopic liver surgery: a single-center analysis of 600 consecutive patients in 6 years
title Robotic vs. laparoscopic liver surgery: a single-center analysis of 600 consecutive patients in 6 years
title_full Robotic vs. laparoscopic liver surgery: a single-center analysis of 600 consecutive patients in 6 years
title_fullStr Robotic vs. laparoscopic liver surgery: a single-center analysis of 600 consecutive patients in 6 years
title_full_unstemmed Robotic vs. laparoscopic liver surgery: a single-center analysis of 600 consecutive patients in 6 years
title_short Robotic vs. laparoscopic liver surgery: a single-center analysis of 600 consecutive patients in 6 years
title_sort robotic vs. laparoscopic liver surgery: a single-center analysis of 600 consecutive patients in 6 years
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283354/
https://www.ncbi.nlm.nih.gov/pubmed/35641702
http://dx.doi.org/10.1007/s00464-021-08770-x
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