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Is the robotic approach the future of distal pancreatectomy with splenectomy? A propensity score matched analysis

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Abstract

Our study provides a comparative analysis of the Laparo-Endoscopic Single Site (LESS) and robotic surgical approaches for distal pancreatectomy and splenectomy, examining their cosmetic advantages, patient outcomes, and operative efficiencies through propensity score matching (PSM). We prospectively followed 174 patients undergoing either the LESS or robotic procedure, matched by cell type, tumor size, age, sex, and BMI from 2012 to 2023. Propensity score matching (PSM) was utilized for data adjustment, with results presented as median (mean ± SD). Post-PSM analysis showed no significant differences in age or BMI between the two groups. LESS approach exhibited a shorter operative duration (180(180 ± 52.0) vs. 248(262 ± 78.5) minutes, p = 0.0002), but increased estimated blood loss (200(317 ± 394.4) vs. 100 (128 ± 107.2) mL, p = 0.04). Rates of intraoperative and postoperative complications, length of hospital stay, readmissions within 30 days, in-hospital mortalities, and costs were comparably similar between the two procedures. While the robotic approach led to lower blood loss, LESS was more time-efficient. Patient outcomes were similar in both methods, suggesting that the choice between these surgical techniques should balance cosmetic appeal with technical considerations.

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Data availability

Due to the sensitive nature of the research data and the privacy constraints imposed by our study protocol, the data that support the findings of this study are not publicly available. All relevant data are protected to ensure participant confidentiality and comply with ethical standards.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Digestive Health Institute AdventHealth Tampa, Tampa, FL, USA

    Sharona B. Ross, Iswanto Sucandy, Prakash Vasanthakumar, Maria Christodoulou, Tara M. Pattilachan, Cameron Syblis & Alexander Rosemurgy

  2. University of South Florida Morsani College of Medicine Tampa, Tampa, FL, USA

    Prakash Vasanthakumar & Cameron Syblis

Authors
  1. Sharona B. Ross
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  2. Iswanto Sucandy
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  3. Prakash Vasanthakumar
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  4. Maria Christodoulou
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  5. Tara M. Pattilachan
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  6. Cameron Syblis
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  7. Alexander Rosemurgy
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Contributions

Conceptualization: SBR, IS, PV, MC, TMP, CS, and AR; methodology: SBR, IS, PV, MC, TMP, CS, and AR; formal analysis and investigation: SBR, IS, PV, MC, T.M.P., CS, and AR; writing—original draft preparation: SBR, IS, PV, MC, TMP, CS, and AR; writing—review and editing: SBR, IS, PV, MC, TMP, CS, and AR; resources: SBR, IS, PV, MC, TMP, CS, and AR; supervision: SBR, IS, PV, MC, TMP, CS, and AR

Corresponding author

Correspondence to Sharona B. Ross.

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Conflict of interest

Cameron Syblis, Prakash Vasanthakumar, Maria Christodoulou, Tara M. Pattilachan, Iswanto Sucandy, and Alexander Rosemurgy have no conflicts of interest or financial ties to disclose. Dr. Sharona B. Ross is a consultant for Intuitive Surgical (Sunnyvale, CA) and Ethicon (Cincinnati, OH). Dr. Sharona B. Ross receives educational grants for the Women in Surgery Career Symposium from Intuitive Surgical and Medtronic (Minneapolis, MN).

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Ross, S.B., Sucandy, I., Vasanthakumar, P. et al. Is the robotic approach the future of distal pancreatectomy with splenectomy? A propensity score matched analysis. J Robotic Surg 18, 148 (2024). https://doi.org/10.1007/s11701-024-01906-w

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  • DOI: https://doi.org/10.1007/s11701-024-01906-w

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