Robotic approach to the liver: Open surgery in a closed abdomen or laparoscopic surgery with technical constraints?

Troisi, Roberto; Pegoraro, Francesca; Giglio, Mariano Cesare; Rompianesi, Gianluca; Berardi, Giammauro; Tomassini, Federico; Simone, G.; Aprea, Giovanni; Montalti, Roberto; Palma, Giovanni Domenico De

doi:10.1016/j.suronc.2019.10.012

Cited by 32 publications

(26 citation statements)

References 113 publications

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“…In anatomical standard major hepatectomy, LLR is a viable alternative to open liver resection when vascular or biliary reconstruction is not required [ 58 ]. However, vascular or biliary reconstruction is technically easier with robot-assisted system [ 59 ]. Our subgroup analysis showed that RLR has certain advantages in major hepatectomy compared with LLR, which had no statistically significant difference in clinical results except for lower estimated blood loss.…”

Section: Discussionmentioning

confidence: 99%

Comparative clinical outcomes of robot-assisted liver resection versus laparoscopic liver resection: A meta-analysis

Zhang

Yuan

et al. 2020

PLoS ONE

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Background As an emerging technology, robot-assisted surgical system has some potential merits in many complicated endoscopic procedures compared with laparoscopic surgery. But robotassisted liver resection is still a controversial problem on its advantages compared with laparoscopic liver resection. We aimed to perform the meta-analysis to assess and compare the clinical outcomes of robot-assisted and laparoscopic liver resection. Methods We searched PubMed, Cochrane Library, Embase databases, Clinicaltrials, and Opengrey through March 24, 2020, including references of qualifying articles. English-language, original investigations in humans about robot-assisted and laparoscopic hepatectomy were included. Titles, abstracts, and articles were reviewed by at least 2 independent readers. Continuous and dichotomous variables were compared by the weighted mean difference (WMD) and odds ratio (OR), respectively. Results Of 936 titles identified in our original search, 28 articles met our criteria, involving 3544 patients. Compared with laparoscopy, the robot-assisted groups had longer operative time

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Section: Discussionmentioning

confidence: 99%

Comparative clinical outcomes of robot-assisted liver resection versus laparoscopic liver resection: A meta-analysis

Zhang

Yuan

et al. 2020

PLoS ONE

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“…Especially for younger patients, there is an urgent need for aesthetics of the wound and high quality of life after operation. Compared with laparoscopy, robotic surgery has distinct technical advantages, including the high-definition three-dimensional stereoscopic visualization, the flexible biomimetic mechanical wrist, and the stable tremor-free arm[ 20 , 21 ]. These advantages allow for the precise dissection and fine suturing required in pancreatic surgery[ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: Single-center experience with 82 patients

Zhao

Jiang

Gao

et al. 2020

WJGO

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BACKGROUND Mucinous cystic neoplasm (MCN) of the pancreas is characterized by mucin-producing columnar epithelium and dense ovarian-type stroma and at risk for malignant transformation. Early diagnosis and treatment of MCN are particularly important. AIM To investigate the clinical characteristics of and management strategies for pancreatic mucinous cystadenoma (MCA) and mucinous cystadenocarcinoma (MCC). METHODS The clinical and pathological data of 82 patients with pancreatic MCA and MCC who underwent surgical resection at our department between April 2015 and March 2019 were retrospectively analyzed. RESULTS Of the 82 patients included in this study, 70 had MCA and 12 had MCC. Tumor size of MCC was larger than that of MCA ( P = 0.049). Age and serum levels of tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and CA12-5 were significantly higher in MCC than in MCA patients ( P = 0.005, 0.026, and 0.037, respectively). MCA tumor size was positively correlated with serum CA19-9 levels ( r = 0.389, P = 0.001). Compared with MCC, MCA had a higher minimally invasive surgery rate ( P = 0.014). In the MCA group, the rate of major complications was 5.7% and that of clinically relevant pancreatic fistula was 8.6%; the corresponding rates in the MCC group were 16.7% and 16.7%, respectively. CONCLUSION Tumor size, age, and serum CEA, CA19-9, and CA12-5 levels may contribute to management of patients with MCN. Surgical resection is the primary treatment modality for MCC and MCA.

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“…The application of the minimally invasive approach (laparoscopic and robotic interventions) has been shown to be safe and effective for oncological and liver surgeries and is in constant development [10,11].…”

Section: Description Of the Interventionmentioning

confidence: 99%

Eficacia de la hepatectomía robótica frente a la hepatectomía laparoscópica en pacientes con tumores hepáticos

Palomeque¹,

Castro²,

Izquierdo

2021

REV-SEP

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Introducción: La resección hepática sigue siendo el método más efectivo de tratamiento de tumores hepáticos. Actualmente, el abordaje laparoscópico se considera como el estándar de oro frente al abordaje abierto; sin embargo, el surgimiento de la cirugía robótica brinda una nueva opción de abordaje mínimamente invasiva con aparentes mejores resultados. El objetivo de esta revisión sistemática es valorar los beneficios de la hepatectomía robótica frente a la hepatectomía laparoscópica en la resección de tumores hepáticos. Metodología: En esta revisión sistemática se incluirán estudios comparativos, de cohorte, de casos y controles, con recolección de datos prospectivos o retrospectivos. Los participantes de los estudios serán pacientes diagnosticados con tumores hepáticos benignos o malignos, incluidos niños y adolescentes, no cirróticos o cirróticos compensados sometidos a intervenciones de hepatectomía robótica y hepatectomía laparoscópica. Las medidas de resultado primarias son: 1. Pérdida de sangre estimada durante el acto quirúrgico, 2. Tiempo operatorio, 3. Tasa de conversión a laparotomía, 4. Tasa de mortalidad intraoperatoria, 5. Tasa de morbilidad (complicaciones postquirúrgicas), 6. Estancia hospitalaria postquirúrgica. Las búsquedas electrónicas se realizarán en PUBMED, MEDLINE, SCIENCEDIRECT (2010 hasta el presente). Se usará la evaluación del riesgo de sesgo de estudios de Cochrane. Como medidas de efecto del tratamiento se utilizarán las diferencias de medias (DM) y los intervalos de confianza (IC) del 95. La evaluación de heterogeneidad se realizará mediante la inspección visual del diagrama de embudo. La evaluación de la calidad de la evidencia y tablas de 'Resumen de hallazgos' se usará el test GRADE.

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Robotic approach to the liver: Open surgery in a closed abdomen or laparoscopic surgery with technical constraints?

Cited by 32 publications

References 113 publications

Comparative clinical outcomes of robot-assisted liver resection versus laparoscopic liver resection: A meta-analysis

Comparative clinical outcomes of robot-assisted liver resection versus laparoscopic liver resection: A meta-analysis

Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: Single-center experience with 82 patients

Eficacia de la hepatectomía robótica frente a la hepatectomía laparoscópica en pacientes con tumores hepáticos

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