Robotic-assisted versus open left pancreatectomy for cystic tumours: A single-centre experience

Abstract

Robotically assisted LSP is a safe and effective procedure. It is accompanied by a significantly higher spleen preservation rate compared to the open approach. In addition, because of the reduced trauma, RAS incurred a shorter post-operative hospital stay and faster return to full recovery, particularly important in patients undergoing surgery for relative indications. However, these benefits of RAS for LSP require confirmation by prospective randomised controlled studies.

Systematic review and meta-analysis of risk factors of postoperative pancreatic fistula after distal pancreatectomy in the era of 2016 International Study Group pancreatic fistula definition

“…Open versus minimally invasive surgery Fifteen studies investigated the impact of open and minimally invasive DP on CR-POPF rate in 1831 patients. 4,15,18,19,21,22,25,29,31,34,35,41,48,50,54 There was no difference in CR-POPF rate between open DP group (25.0%, 313/ 1254) and minimally invasive DP group (14.4%, 83/577) (OR 1.35, 95%-CI: 0.91-2.01, p = 0.12, Fig. 3a).…”

“…3a). However, further subgroup analysis of studies with 10 patients per arm, involving 13 studies, 4,15,18,19,21,22,25,29,31,34,41,48,50 showed CR-POPF was significantly higher after open DP (24.9%, 285/ 1145) than minimally invasive DP (14.0%, 80/571) (OR 1.43, 95%-CI: 1.02-2.01, p = 0.04, 3 b).…”

“…Thirty-four studies were retrospective cohort studies, 2,4,14-45 three were prospective cohort studies, [46][47][48] two were randomized-controlled trials, 49,50 two were propensity matched studies (retrospective 51 and prospective 52 ), one was a retrospective matched-pair analysis, 53 and one was a case-control study. 54 performed in Japan (n = 14), 15,21,24,25,30,31,33,34,39,42,43,45,48,54 USA (n = 6), 14,17,26,35,47,51 Italy (n = 5), 20,22,27,46,52 China (n = 5), 4,32,36,38,44 Germany (n = 3), 23,40,53 Korea (n = 2), 29,36 Finland (n = 2), 37,49 France (n = 1), 28 Taiwan (n = 1), 16 Sweden (n = 1), …”

“…2,4, The weighted incidence of POPF B and C were 20.2% (95%-CI: 16.9-24.0%) and 1.6% (95%-CI: 1.2-2.2%), respectively. 2,4,16,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][37][38][39][40][41][44][45][46][49][50][51][52][53][54] Meta-analysis of risk factors…”

Minimally invasive distal pancreatectomy: a case-matched cost-analysis between robot-assisted surgery and direct manual laparoscopy

“…In fact, the reduced docking time of the da Vinci Xi with respect to the da Vinci Si, as well as the improvement of the surgical workflow, represent two well consolidated advantages of the latest version of the da Vinci System, that can independently influence the OT and therefore, indirectly, also the costs. In our series, several factors might contribute to explain the reduction of operative time and PCs of Xi-RDP also in comparison with LDP, firstly the higher experience with RAS [ 15 ], and secondly the advantages of RAS over DML that simplify the execution of all the difficult tasks of LDP, such as dissection of the pancreatic body and tail from splenic vessels, suturing, control of bleeding, completion of the retropancreatic tunnel, and suturing the pancreatic stump with the closure of Wirsung duct [ 25 ].…”