Nationwide outcomes and costs of laparoscopic and robotic vs. open hepatectomy

Cortolillo, Nicholas; Patel, Chetan K.; Parreco, Joshua; Kaza, Srinivas; Castillo, A.

doi:10.1007/s11701-018-0896-0

Cited by 38 publications

(26 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among the key findings in this study are a significantly reduced postoperative intensive care unit admission and 90-day readmission rates in the robotic group [29]. This was further supported by a report from Cortolillo et al [30] using large registry data from the Nationwide Readmission Database. Compared to open (n = 10 146) and laparoscopic (n = 520) hepatectomy, robotic procedures (n = 204) were associated with a shorter length of stay and less frequent non-elective readmission within 45 days.…”

Section: Enhanced Recovery a Key Step In Reducing Cost And Improvingsupporting

confidence: 84%

Robotic Liver Surgery – Current Standards and Future Perspectives

et al. 2021

View full text Add to dashboard Cite

Background Robotic liver surgery is emerging as the future of minimal invasive surgery. The robotic surgical system offers a stable camera platform, elimination of physiologic tremor, augmented surgical dexterity as well as improved ergonomics because of a seated operating position. Due to the theoretical advantages of the robotic assisted system, complex liver surgery might be an especially interesting indication for a robotic approach since it demands delicate tissue dissection, precise intracorporeal suturing as well as difficult parenchymal transection with subsequent need for meticulous hemostasis and biliostasis. Material and methods An analysis of English and German literature on open, laparoscopic and robotic liver surgery was performed and this review provides a general overview of the existing literature along with current standards and aims to specifically point out future directions of robotic liver surgery. Results Robotic liver surgery is safe and feasible compared to open and laparoscopic surgery, with improved short-term postoperative outcomes and at least non-inferior oncological outcomes. Conclusion In complex cases including major hepatectomies, extended hepatectomies with biliary reconstruction and difficult segmentectomies of the posterior-superior segments, robotic surgery appears to emerge as a reasonable alternative to open surgery rather than being an alternative to laparoscopic procedures.

show abstract

Section: Enhanced Recovery a Key Step In Reducing Cost And Improvingsupporting

confidence: 84%

Robotic Liver Surgery – Current Standards and Future Perspectives

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Our 6 per cent 30-day readmission rate was also similar to the rates reported in recent publications, ranging from 6 to 16 per cent. 2,8 The limitation of this study is related to its short interval follow-up because most of the hepatectomies were undertaken in 2017 to 2018. We are prospectively collecting medium and long-term data to better understand the oncologic and survival outcomes of this approach.…”

Section: Discussionmentioning

confidence: 99%

“…A better understanding of surgical anatomy and liver regenerative capacity, as well as improvement in surgical instrumentation, has facilitated safer liver resection including for large tumors, used to be considered unresectable. Better techniques and surgical instruments to bloodlessly transect the liver parenchyma lead to better outcomes for patients undergoing liver tumor resection 1,2 The first laparoscopic nonanatomic liver resection was performed in 1992; since then, the techniques of liver surgery have evolved. 3 The indications and surgical steps became standardized for both open and the newer minimally invasive technique.…”

mentioning

confidence: 99%

Institutional First 100 Case Experience and Outcomes of Robotic Hepatectomy for Liver Tumors

Sucandy

Giovannetti

Ross

et al. 2020

The American Surgeon™

View full text Add to dashboard Cite

The nascent robotic approach for hepatic resections is gaining momentum in the United States because it offers solutions to the known limitations of laparoscopic approach. Herein, we report our initial experience and short-term outcomes of the first 100 robotic hepatectomies. With Institutional Review Board approval, all patients undergoing robotic hepatectomy were prospectively followed up. Patient demographics, operative outcomes, complications, and 30-day readmissions were collected and analyzed. Data are presented as median (mean ± SD). One hundred consecutive patients underwent robotic hepatectomy. Patients were aged 62 (63 ± 13.6) years, 66 per cent were women, and BMI was 29 (29 ± 6.4) kg/m2. In all, 76 per cent of the hepatectomies were undertaken for malignancy [metastatic colorectal cancer (28%), hepatocellular carcinoma (21%), and intrahepatic cholangiocarcinoma (15%)], and 20 per cent for benign lesions; 66 per cent of patients underwent nonanatomical partial hepatectomies, 17 per cent right hepatectomies, 16 per cent left hepatectomies, and 1 per cent trisegmentectomy. Operative time was 233 (268 ± 109.3) minutes, and the estimated blood loss was 123 (269 ± 322.1) mL. Conversion to “open” approach was necessary in one patient. The length of stay was 3 (5 ± 4.6) days. There were no intraoperative complications. Twelve patients experienced postoperative complications. Six patients required readmission to the hospital within 30 days of discharge. Robotic hepatectomy is safe and feasible with favorable short-term outcomes. The robotic system enhances application of minimally invasive surgery for complex hepatobiliary operations.

show abstract

“…Second, the possibility to widen the range of application of MIS for MH should be also taken into account. Minimally invasive and conventional open hepatectomy have been recently compared by Cortolillo et al 45 . based on the National Readmission Database 46 .…”

Section: Discussionmentioning

confidence: 99%

Robot‐assisted versus conventional laparoscopic major hepatectomies: Systematic review with meta‐analysis

Coletta

Sandri

Giuliani

et al. 2021

Robotics Computer Surgery

View full text Add to dashboard Cite

Background Major hepatectomy is still regarded as a technically demanding procedure for which minimally invasive surgery remains limited to selected cases in experienced centres and robotic platforms may provide some advantages over conventional laparoscopy in this setting. We aimed to combine and meta‐analyse the available literature upon this topic. Methods The PubMed, MEDLINE and Web of Science databases were appraised to find all available studies comparing robotic and laparoscopic major hepatectomies. According to a pre‐established pattern preoperative settings, operative and postoperative outcomes were assessed. The meta‐analysis was performed by using the Revman 5.3 software. Results A total of 485 patients from eight studies were included in the analysis. Robotic major hepatectomies showed a significantly lower conversion rate and estimated blood loss as compared to laparoscopic ones. Laparoscopic major hepatectomies patients experienced significant shorter postoperative hospitalisation. Conclusions Robotic surgery appears as competent as conventional laparoscopy to perform major hepatectomies, with possible advantages on conversion rate and perioperative blood loss, despite slightly prolonged postoperative hospitalisation.

show abstract

Nationwide outcomes and costs of laparoscopic and robotic vs. open hepatectomy

Cited by 38 publications

References 28 publications

Robotic Liver Surgery – Current Standards and Future Perspectives

Robotic Liver Surgery – Current Standards and Future Perspectives

Institutional First 100 Case Experience and Outcomes of Robotic Hepatectomy for Liver Tumors

Robot‐assisted versus conventional laparoscopic major hepatectomies: Systematic review with meta‐analysis

Contact Info

Product

Resources

About