Laparoscopic vs. open left lateral sectionectomy: an update systematic review and meta-analysis of randomized and non-randomized controlled trials

Macacari, Rodrigo; Coelho, Fabrício Ferreira; Bernardo, Wanderlei M.; Krüger, Jaime Arthur Pirola; Jeismann, Vagner Birk; Fonseca, Gilton Marques; Cesconetto, Danielle Menezes; Ivan, Cristina; Herman, Paulo

doi:10.1016/j.hpb.2018.06.2818

Cited by 3 publications

(2 citation statements)

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“…Apesar das vantagens potenciais, a maioria das séries mostraram resultados semelhantes entre ressecções hepáticas laparoscópicas e robóticas. 52,81,82 Alguns autores propõem que a cirurgia robótica teria maior benefício em ressecções hepáticas com maior complexidade, como as de lesões posterosuperiores e hepatectomias maiores. 83,84 Estudo multicêntrico recente, incluindo 29 centros (n=989 pacientes) comparou os resultados perioperatórios de pacientes submetidos à hepatectomia direita ou direita ampliada robótica (n=220) e laparoscópica (n=769).…”

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“…[46][47][48] Atualmente, para as ressecções menores anterolaterais e setorectomia lateral esquerda, a via de acesso minimamente invasiva é considerada a padrão-ouro, pela menor complexidade técnica, possibilidade de padronização dos passos cirúrgicos e resultados superiores à abordagem convencional. [49][50][51][52] Em metanálise recente, Macacari et al 52 incluindo 23 estudos (n=3.415 pacientes) demonstraram que a setorectomia lateral esquerda minimamente invasiva cursa com menor perda sanguínea, menor taxa de transfusão de hemoderivados e menor tempo de internação hospitalar, quando comparada à cirurgia convencional.…”

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Hepatectomia direita minimamente invasiva versus aberta: estudo comparativo com pareamento por pontuação de propensão

Duarte

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Aos meus pais, Wagner e Ana, pelo exemplo de superação, incentivo, dedicação e carinho incondicionais, fundamentais para meu desenvolvimento.Aos meus irmãos, Victor e Vanessa, pela amizade e companheirismo.À minha esposa, Tiane, pelo amor, carinho e incentivo, sempre ao meu lado nessa jornada.À minha filha, Lara, minha maior alegria e inspiração para ser o melhor possível.Ao meu filho (a) que chegará em breve, e já transborda nossos corações de felicidade e amor. AGRADECIMENTOSAo Professor Fabricio Ferreira Coelho, meu orientador, pelos ensinamentos, incentivo e apoio durante essa jornada. Grande entusiasta da pesquisa, um dos maiores pesquisadores e cirurgiões do Brasil. Teve papel fundamental na criação e condução deste trabalho.

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Hepatectomia direita minimamente invasiva versus aberta: estudo comparativo com pareamento por pontuação de propensão

Duarte

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Minimally invasive surgery approaches in major liver resection for hepatocellular carcinoma

Chatzipanagiotou,

Catalano,

Kawashima

et al. 2024

Hepatoma Res

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Over the past two decades, minimally invasive liver resection (MILR) has progressively become the standard for minor resection of hepatocellular carcinoma (HCC). In contrast, its implementation in major hepatectomy has been slower due to its higher technical complexity and morbidity. However, studies published in recent years have demonstrated that minimally invasive major hepatectomy (MIMH) is safe and feasible with less blood loss, fewer complications, earlier recovery, decreased hospital stay, and improved cosmetic outcomes compared with open surgery. This review examines the current status of MIMH, focusing on the respective strengths and weaknesses of the laparoscopic and robotic approaches, as well as assessing their cost-effectiveness and possible future directions. The earlier introduction of laparoscopic liver resection has led to its widespread utilization as a safe and accurate alternative to open hepatectomy. Of note is that the robotic approach has also been increasingly utilized, demonstrating better perioperative outcomes and decreased need for conversion to open hepatectomy vs. the laparoscopic approach. Advantages associated with the robotic approach include the three-dimensional large visual field and instrumental flexibility, allowing for improved bleeding control. Even though evidence has been slowly accumulating regarding long-term outcomes, most studies report no notable differences between open, robotic, and laparoscopic resection for HCC. Regarding cost-effectiveness, MIMH has been characterized by higher operating room and anesthesia costs, especially for robotic procedures that require highly expensive equipment. The increase in cost is often offset by the lower morbidity and, thus, shorter hospital stays associated with MIMH. Future developments, such as the implementation of artificial intelligence and augmented reality, may potentially maximize the safety and applicability of MIMH and, in time, lead to improved postoperative and oncological outcomes.

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Liver parenchyma dissection in Totally robotic liver surgery - Results of the first 100 patients using the Robotic Harmonic curved shears

Fukumori,

Tschuor,

Penninga

et al. 2023

Mini-invasive Surg

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Aim: Robotic liver surgery (RLS) is a feasible and safe procedure. However, limitations of the robotic instruments used for liver parenchyma dissection compared to laparoscopic and open approaches are major drawbacks of RLS. There is no established technique for liver parenchymal dissection in RLS. The aim of this study is to discuss the surgical outcomes of Totally RLS using Robotic Harmonic curve shears at the University Hospital of Copenhagen, Denmark. Methods: Between June 2019 and June 2022, RLS was performed with 100 patients. Patient variables and short-term outcomes were retrospectively analysed. Results: The mean patient age was 63.1 years; the median operating time was 246 min; and the median estimated blood loss was 100 mL. Thirty-two patients underwent subsegmentectomy, 18 mono-segmentectomies, 25 bi-segmentectomies, and 25 major hepatectomies. One patient (1.0%) required conversion to open surgery. Five patients experienced postoperative major complications (Clavien-Dindo classification ≥ IIIa) while no mortalities occurred. Median length of hospital stay was 3 days. There were no significant differences between minor and major hepatectomies in any of the factors. Conclusion: Based on our study of minor and major hepatectomies in Totally RLS, we conclude that the use of the Robotic Harmonic curve shear for liver parenchyma dissection is feasible and safe.

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Laparoscopic vs. open left lateral sectionectomy: an update systematic review and meta-analysis of randomized and non-randomized controlled trials

Cited by 3 publications

References 0 publications

Hepatectomia direita minimamente invasiva versus aberta: estudo comparativo com pareamento por pontuação de propensão

Hepatectomia direita minimamente invasiva versus aberta: estudo comparativo com pareamento por pontuação de propensão

Minimally invasive surgery approaches in major liver resection for hepatocellular carcinoma

Liver parenchyma dissection in Totally robotic liver surgery - Results of the first 100 patients using the Robotic Harmonic curved shears

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