Langenbeck's Archives of Surgery

, Volume 399, Issue 8, pp 1039–1045 | Cite as

Robotic versus laparoscopic liver resection: a comparative study from a single center

  • Young-Dong Yu
  • Ki-Hun Kim
  • Dong-Hwan Jung
  • Jung-Man Namkoong
  • Sam-Youl Yoon
  • Sung-Won Jung
  • Sang-Kyung Lee
  • Sung-Gyu Lee
Original Article

Abstract

Purpose

The significant advantages of robotic surgery have expanded the scope of surgical procedures that can be performed through minimally invasive techniques. The aim of this study was to compare the perioperative outcomes between robotic and laparoscopic liver surgeries at a single center.

Methods

From July 2007 to October 2011, a total of 206 patients underwent laparoscopic or robotic liver surgery at the Asan Medical Center, Seoul, Korea. We compared the surgical outcomes between robotic liver surgery and laparoscopic liver surgery during the same period. Only patients who underwent left hemihepatectomy or left lateral sectionectomy were included in this study.

Results

The robotic group consisted of 13 patients who underwent robotic liver resection including 10 left lateral sectionectomies and three left hemihepatectomies. The laparoscopic group consisted of 17 patients who underwent laparoscopic liver resection during the same period including six left lateral sectionectomies and 11 left hemihepatectomies. The groups were similar with regard to age, gender, tumor type, and tumor size. There were no significant differences in perioperative outcome such as operative time, intraoperative blood loss, postoperative liver function tests, complication rate, and hospital stay between robotic liver resection and laparoscopic liver resection. However, the medical cost was higher in the robotic group.

Conclusions

Robotic liver resection is a safe and feasible option for liver resection in experienced hands. The authors suggest that since the robotic surgical system provides sophisticated advantages, the retrenchment of medical cost for the robotic system in addition to refining its liver transection tool may substantially increase its application in clinical practice in the near future.

Keywords

Robotic liver resection Laparoscopic liver resection Perioperative outcome Safe 

Notes

Conflicts of interest

All authors have no conflicts of interest or financial ties to disclose.

References

  1. 1.
    Idrees K, Bartlett DL (2010) Robotic liver surgery. Surg Clin North Am 90(4):761–774PubMedCrossRefGoogle Scholar
  2. 2.
    Kim KH, Jung DH, Park KM, Lee YJ, Kim DY, Kim KM, Lee SG (2011) Comparison of open and laparoscopic live donor left lateral sectionectomy. Br J Surg 98(9):1302–1308. doi: 10.1002/bjs.7601 PubMedCrossRefGoogle Scholar
  3. 3.
    Pilgrim CH, To H, Usatoff V, Evans PM (2009) Laparoscopic hepatectomy is a safe procedure for cancer patients. HPB (Oxford) 11(3):247–251. doi: 10.1111/j.1477-2574.2009.00045.x CrossRefGoogle Scholar
  4. 4.
    Simillis C, Constantinides VA, Tekkis PP, Darzi A, Lovegrove R, Jiao L, Antoniou A (2007) Laparoscopic versus open hepatic resections for benign and malignant neoplasms—a meta-analysis. Surgery 141(2):203–211PubMedCrossRefGoogle Scholar
  5. 5.
    Berber E, Akyildiz HY, Aucejo F, Gunasekaran G, Chalikonda S, Fung J (2010) Robotic versus laparoscopic resection of liver tumours. HPB (Oxford) 12(8):583–586. doi: 10.1111/j.1477-2574.2010.00234.x CrossRefGoogle Scholar
  6. 6.
    Lai EC, Tang CN, Li MK (2012) Robot-assisted laparoscopic hemi-hepatectomy: technique and surgical outcomes. Int J Surg 10(1):11–15PubMedCrossRefGoogle Scholar
  7. 7.
    Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Tsinberg M, Tellioglu G, Simpfendorfer CH, Walsh RM, Walsh MR, Vogt D, Fung J, Berber E (2009) Comparison of laparoscopic versus open liver tumor resection: a case-controlled study. Surg Endosc 23(4):847–853. doi: 10.1007/s00464-008-0262-9 PubMedCrossRefGoogle Scholar
  9. 9.
    Koffron AJ, Auffenberg G, Kung R, Abecassis M (2007) Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg 246(3):385–392. doi: 10.1097/SLA.0b013e318146996c PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS (2009) The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg 250(5):825–830PubMedCrossRefGoogle Scholar
  11. 11.
    Choi SB, Park JS, Kim JK, Hyung WJ, Kim KS, Yoon DS, Lee WJ, Kim BR (2008) Early experiences of robotic-assisted laparoscopic liver resection. Yonsei Med J 49(4):632–638PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Giulianotti PC, Coratti A, Sbrana F, Addeo P, Bianco FM, Buchs NC, Annechiarico M, Benedetti E (2011) Robotic liver surgery: results for 70 resections. Surgery 149(1):29–39. doi: 10.1016/j.surg.2010.04.002 PubMedCrossRefGoogle Scholar
  13. 13.
    Vidovszky TJ, Smith W, Ghosh J, Ali MR (2006) Robotic cholecystectomy: learning curve, advantages, and limitations. J Surg Res 136(2):172–178. doi: 10.1016/j.jss.2006.03.021 PubMedCrossRefGoogle Scholar
  14. 14.
    Hashizume M, Tsugawa K (2004) Robotic surgery and cancer: the present state, problems and future vision. Jpn J Clin Oncol 34(5):227–237PubMedCrossRefGoogle Scholar
  15. 15.
    Nguyen MM, Das S (2004) The evolution of robotic urologic surgery. Urol Clin North Am 31(4):653–658. doi: 10.1016/j.ucl.2004.06.002, viiPubMedCrossRefGoogle Scholar
  16. 16.
    Dagher I, Proske JM, Carloni A, Richa H, Tranchart H, Franco D (2007) Laparoscopic liver resection: results for 70 patients. Surg Endosc 21(4):619–624. doi: 10.1007/s00464-006-9137-0 PubMedCrossRefGoogle Scholar
  17. 17.
    Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B (2006) Laparoscopic liver resection. Br J Surg 93(1):67–72. doi: 10.1002/bjs.5150 PubMedCrossRefGoogle Scholar
  18. 18.
    Bryant R, Laurent A, Tayar C, Cherqui D (2009) Laparoscopic liver resection-understanding its role in current practice: the Henri Mondor Hospital experience. Ann Surg 250(1):103–111. doi: 10.1097/SLA.0b013e3181ad6660 PubMedCrossRefGoogle Scholar
  19. 19.
    Buell JF, Thomas MT, Rudich S, Marvin M, Nagubandi R, Ravindra KV, Brock G, McMasters KM (2008) Experience with more than 500 minimally invasive hepatic procedures. Ann Surg 248(3):475–486. doi: 10.1097/SLA.0b013e318185e PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Young-Dong Yu
    • 1
  • Ki-Hun Kim
    • 2
  • Dong-Hwan Jung
    • 2
  • Jung-Man Namkoong
    • 2
  • Sam-Youl Yoon
    • 2
  • Sung-Won Jung
    • 2
  • Sang-Kyung Lee
    • 2
  • Sung-Gyu Lee
    • 2
  1. 1.Department of Surgery, Division of HBP Surgery & Liver TransplantationKorea University College of MedicineSeoulSouth Korea
  2. 2.Division of Hepatobiliary Surgery and Liver Transplantation, Department of SurgeryUniversity of Ulsan College of Medicine and Asan Medical CenterSeoulSouth Korea

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