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. 2023 Feb;17(1):79-88.
doi: 10.1007/s11701-022-01405-w. Epub 2022 Mar 24.

Transition from laparoscopic to robotic liver surgery: clinical outcomes, learning curve effect, and cost-effectiveness

M D'Hondt #  1 , A Devooght #  2 , E Willems  2 , D Wicherts  3 , C De Meyere  2 , I Parmentier  4 , A Provoost  2 , H Pottel  5 , C Verslype  6
Affiliations

Transition from laparoscopic to robotic liver surgery: clinical outcomes, learning curve effect, and cost-effectiveness

M D'Hondt et al. J Robot Surg. 2023 Feb.

Abstract

The reproducibility of the implementation of robotic liver surgery (RLS) is still debated. The aim of the present study is to evaluate short-term outcomes and cost differences during the implementation of RLS, performed by an early adopter in laparoscopic liver surgery (LLS). Patients undergoing RLS between February 2020 and May 2021 were included. Short-term outcomes of the robotic group (RG) were compared to the "Initial Phase" group (IP) of 120 LLS cases and the 120 most recent laparoscopic cases or "Mastery Phase" group (MP). A cost analysis per procedure for the three groups was performed. Seventy-one patients underwent RLS during the study period. Median operative time in the RG was comparable to the IP, but significantly shorter in the MP (140 vs 138 vs 120 min, p < 0.001). Median intraoperative blood loss in the RG was lower than in both laparoscopic groups (40 ml [20-90 ml] vs 150 ml [50-250 ml] vs 80 ml [30-150 ml], p < 0.001). Median hospital stay in the RG was significantly shorter than the IP group (p < 0.001). There were no significant differences in postoperative complication, conversion, or readmission rates. Procedural cost analysis was in favor of robotic surgery (€5008) compared to the IP (€ 6913) and the MP (€6099). Surgeons with sufficient experience in LLS can rapidly overcome the learning curve for RLS. In our experience, the short-term outcomes of the implementation phase of RLS are similar to the mastery phase of LLS. The total average cost per procedure is lower for RLS compared to LLS.

Keywords: Clinical outcomes; Cost analysis; Liver surgery; Robotic hepatectomy.

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References

    1. Ciria R, Cherqui D, Geller D, Briceno J, Wakabayashi G (2016) Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg 263(4):761–777. https://doi.org/10.1097/sla.0000000000001413 - DOI - PubMed
    1. Berardi G, Van Cleven S, Fretland Å et al (2017) Evolution of laparoscopic liver surgery from innovation to implementation to mastery: perioperative and oncologic outcomes of 2,238 patients from 4 European specialized centers. J Am Coll Surg 225(5):639–649. https://doi.org/10.1016/j.jamcollsurg.2017.08.006 - DOI - PubMed
    1. Abu Hilal M, Aldrighetti L, Dagher I et al (2018) The Southampton consensus guidelines for laparoscopic liver surgery. Ann Surg 268(1):11–18. https://doi.org/10.1097/sla.0000000000002524 - DOI - PubMed
    1. Kawai T, Goumard C, Jeune F, Savier E, Vaillant J, Scatton O (2018) Laparoscopic liver resection for colorectal liver metastasis patients allows patients to start adjuvant chemotherapy without delay: a propensity score analysis. Surg Endosc 32(7):3273–3281. https://doi.org/10.1007/s00464-018-6046-y - DOI - PubMed
    1. Castaing D, Vibert E, Ricca L, Azoulay D, Adam R, Gayet B (2009) Oncologic results of laparoscopic versus open hepatectomy for colorectal liver metastases in two specialized centers. Ann Surg 250(5):849–855. https://doi.org/10.1097/sla.0b013e3181bcaf63 - DOI - PubMed

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