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Hepato-pancreato-biliary

E297: Robotic versus Open major hepatectomy: A single center matched comparison of outcomes.

    ePoster Abstract Author(s)

  • Mark Hall, MD

    General Surgery Resident
    KU Wichita
    Wichita, Kansas, United States

    • Submitter(s)

  • Mark Hall, MD

    General Surgery Resident
    KU Wichita
    Wichita, Kansas, United States

    • Author(s)

  • Mark Hall, MD

    General Surgery Resident
    KU Wichita
    Wichita, Kansas, United States

  • SC

    Sarah Corn, MD

    Surgical Oncologist
    KU Wichita, United States

  • Ali Ahmad, MD, FACS

    Surgical Oncologist
    KU Wichita
    Wichita, Kansas, United States

Introduction: The robotic platform has widened the breadth of hepatobiliary procedures able to be performed a minimally invasive fashion.  The specific technical advantages offered by the robot have helped increase the adoption of this platform for performing major liver resections.  Objective data on the benefits of this approach is still lacking.

Methods:

A retrospective analysis of patients undergoing major hepatectomy at our institution between 2016 and 2019 was performed.  After individual 1:1 matching was completed, data on robotic (n=40) and open (n=40) major hepatectomy patients was analyzed. Both groups were matched based on demographics, body mass index (BMI), ASA status, underlying liver disease, and type of hepatectomy.

Results:

Robotic major hepatectomy was associated with a significantly longer operative time (302 mins vs 197 mins, p < 0.0001) but significantly lower operative blood loss (EBL, 198 mL vs 357 mL, p = 0.002).  Patients undergoing robotic major hepatectomy had a lower rate of perioperative blood transfusion (OR 0.243, p = 0.044).  Additionally, length of hospital stay was significantly lower in the robotic group (5.1 vs 6.9 days, p = 0.009).  No difference was observed in overall complication rate, R0 resection rate, or mortality.

Conclusions: The robotic approach to major hepatectomy is safe and associated with significantly lower operative blood loss, blood transfusion rate, and hospital length of stay.  More studies are needed to further support these findings and to validate the long-term outcomes of this approach.

Learning Objectives:

  • Upon completion, participants will be able to identify differences in length of stay between open and robotic major hepatectomy.
  • Upon completion, participants will be able to determine benefits in estimated blood loss and need for perioperative blood transfusions in robotic hepatectomy compared to open hepatectomy.
  • Upon completion, participants will be able to identify current limitations in operative time for major liver resections performed on the robotic platform.