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Level 2a evidence comparing robotic versus laparoscopic left lateral hepatic sectionectomy: a meta-analysis

  • Systematic Reviews and Meta-analyses
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Objectives

To evaluate comparative outcomes of robotic and laparoscopic left lateral hepatic sectionectomy (LLS).

Methods

A systematic search of PubMed, Web of Science, EMBASE and bibliographic reference lists with application of a combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators and limits was conducted. Overall, minor (Clavien-Dindo grade < III) and major (Clavien-Dindo grade > III) postoperative complications, mortality, volume of blood loss, conversion to an open procedure, procedure time, length of hospital stay, cost-effectiveness and R1 resection were the evaluated outcome measures.

Results

Seven comparative observational studies reporting a total of 319 patients of whom 150 underwent robotic LLS and the remaining 169 patients underwent laparoscopic LLS were included. The robotic approach was associated with significantly longer procedure time (MD: 29.40 min, p = 0.01) and higher cost (MD: $4170, p < 0.00001) compared to the laparoscopic approach. There was no significant difference in overall postoperative morbidity (OR: 1.29, p = 0.62), Clavien-Dindo grade < III (OR: 1.65, p = 0.49), Clavien-Dindo grade > III (OR: 1.18, p = 0.85), perioperative mortality (RD: 0.00, p = 1.00), volume of blood loss (MD: 1.96 mls, p = 0.91), conversion to an open procedure (RD: − 0.02, p = 0.46), length of hospital stay (MD: 0.22 day, p = 0.52) or R1 resection (RD:0.00, p = 1.00) between two groups.

Conclusions

Meta-analysis of the best available evidence (level 2) demonstrated that robotic LLS is associated with significantly longer procedure time and higher cost and similar perioperative outcomes compared to the laparoscopic approach. Future randomised studies are required to evaluate short-term perioperative, long-term oncological and surgeon-centred outcomes.

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Author information

Author notes

  1. Mohammed Kaif Qayum

    Present address: Hepatobiliary and Pancreatic Surgery and Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, UK

  2. Shahin Hajibandeh and Shahab Hajibandeh equally contributed to this paper, and joint first authorship is proposed.

Authors and Affiliations

  1. Hepatobiliary and Pancreatic Surgery and Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, UK

    Shahin Hajibandeh

  2. Department of General Surgery, Royal Glamorgan Hospital, Cwm Taf University Health Board, Pontyclun, UK

    Shahab Hajibandeh & Karim Hassan

  3. Department of General Surgery, Bradford Royal Infirmary, Bradford, Yorkshire, UK

    Alexios Dosis

  4. Department of Hepato-Pancreato-Biliary Surgery, Royal Blackburn Hospital, Blackburn, UK

    Ambareen Kausar

  5. Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester, UK

    Thomas Satyadas

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  1. Shahin Hajibandeh
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Corresponding author

Correspondence to Shahin Hajibandeh.

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Considering the design of our study, ethical approval and consent were not required.

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Hajibandeh, S., Hajibandeh, S., Dosis, A. et al. Level 2a evidence comparing robotic versus laparoscopic left lateral hepatic sectionectomy: a meta-analysis. Langenbecks Arch Surg 407, 479–489 (2022). https://doi.org/10.1007/s00423-021-02366-8

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  • DOI: https://doi.org/10.1007/s00423-021-02366-8

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