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10 years, 100 robotic major hepatectomies: a single-center experience

  • 2023 SAGES Oral
  • Published:
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Abstract

Introduction

Adoption of robotic liver resections has been gradually increasing throughout the HPB surgical community over the past decade. Currently there is limited literature which demonstrates a significant benefit of robotic surgery for major hepatectomies over open or laparoscopic. As one of the first centers to develop a robotic HPB program, we have experienced improved outcomes over time with increasing utilization of robotics. Herein, we present our 10-year experience and outcomes for major robotic liver resections.

Methods

From 2012 to 2022, 361 robotic liver procedures were performed, including 100 major hepatectomies. A retrospective data review of the electronic medical record was performed evaluating outcomes after robotic major hepatectomy. Outcomes for the first 50 cases (Group A) and second 50 cases (Group B) were compared to identify any improvements in practice. Demographic and clinical outcome variables were analyzed. Data were assessed for normality, and Wilcoxon rank-sum, χ2 tests, and a logistic regression model were performed appropriate for the data. Stata v.17 was utilized, and significance was set as p < .05.

Results

There was no difference in median operative time (258 vs 256 min), EBL (500 vs 500 mL), median LOS (5 vs 3.5 days), 90-day readmission (14% vs 24%), major complications (14% vs 20%), and 90-day mortality (6% vs 4%) between early and late cases, respectively. ICU admissions and conversion rates were significantly lower in group B (14.0% vs 48.0%), while expert level difficulty indices were higher (82% vs 58%).

Conclusion

Development of a robotic liver program with good outcomes is feasible over time. Our data suggest that our institutional learning curve for robotic major hepatectomy plateaued at approximately 50 cases.

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Authors and Affiliations

  1. Division of HPB Surgery, Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA

    Ansley Ricker, Rohit Mantha, Michael Driedger, Michael Beckman, Dionisios Vrochides & John Martinie

  2. Carolinas Center for Surgical Outcomes Science, Atrium Health, Charlotte, NC, USA

    Allyson Cochran

  3. Division of Hepatobiliary & Pancreas Surgery, Department of Surgery, Carolinas Medical Center, Atrium Health, 1025 Morehead Medical Dr. Suite 600, Charlotte, NC, 28204, USA

    Frances McCarron

Authors
  1. Frances McCarron
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  2. Allyson Cochran
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  3. Ansley Ricker
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  4. Rohit Mantha
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  5. Michael Driedger
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  6. Michael Beckman
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  7. Dionisios Vrochides
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Correspondence to Frances McCarron.

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Disclosures

John B. Martinie discloses an affiliation with Intuitive Surgical as a proctor, speaker, and consultant. Dionisios Vrochides also has an affiliation with Intuitive Surgical as a consultant. Frances McCarron discloses her fellowship stipend is sponsored by Intuitive Surgical. Allyson Cochran, Ansley Ricker, Rohit Mantha, Michael Driedger, and Michael Beckman do not have any disclosures.

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McCarron, F., Cochran, A., Ricker, A. et al. 10 years, 100 robotic major hepatectomies: a single-center experience. Surg Endosc 38, 902–907 (2024). https://doi.org/10.1007/s00464-023-10459-2

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  • DOI: https://doi.org/10.1007/s00464-023-10459-2

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