Robotic Living Donor Right Hepatectomy: A Systematic Review and Meta-Analysis

Eddy P Lincango Naranjo^{1

2

3

4}, Estefany Garces-Delgado^{3

5}, Timo Siepmann^{4

6}, Lutz Mirow⁷, Paola Solis-Pazmino⁸, Harold Alexander-Leon^{3

9}, Gabriela Restrepo-Rodas^{3

5}, Rafael Mancero-Montalvo^{3

5}, Cristina J Ponce^{3

5}, Ramiro Cadena-Semanate^{3

5}, Ronnal Vargas-Cordova^{3

10}, Glenda Herrera-Cevallos^{3

11}, Sebastian Vallejo¹, Carolina Liu-Sanchez¹², Larry J Prokop¹³, Ioannis A Ziogas¹⁴, Michail G Vailas¹⁵, Alfredo D Guerron¹⁶, Brendan C Visser¹⁷, Oscar J Ponce^{1

18}, Andrew S Barbas¹⁹, Dimitrios Moris¹⁹

Affiliations

¹ Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55905, USA.
² Department of Teaching and Research, Hospital Vozandes Quito, Quito 170521, Ecuador.
³ Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.
⁴ Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, 01067 Dresden, Germany.
⁵ Medical School, Universidad Internacional del Ecuador, Quito 170411, Ecuador.
⁶ Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany.
⁷ Department of General and Visceral Surgery, Medical Campus Chemnitz of the TU Dresden, 01307 Dresden, Germany.
⁸ Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, CA 94305, USA.
⁹ Medical School, Universidad de las Américas, Quito 170503, Ecuador.
¹⁰ Division of Metabolic and Weight Loss Surgery, Hospital General San Francisco IESS, Quito 170111, Ecuador.
¹¹ Division of Metabolic and Weight Loss Surgery, Hospital Metropolitano, Quito 170521, Ecuador.
¹² Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru.
¹³ Mayo Clinic Libraries, Mayo Clinic, Rochester, MN 55905, USA.
¹⁴ Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
¹⁵ 1st Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
¹⁶ Division of Metabolic and Weight Loss Surgery, Department of Surgery, Duke University, Durham, NC 27705, USA.
¹⁷ Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Stanford University, Stanford, CA 94305, USA.
¹⁸ Frimley Park Hospital, Frimley Health NHS Foundation Trust, Surrey GU16 7UJ, UK.
¹⁹ Department of Surgery, Duke University, Durham, NC 27705, USA.

PMID: 35566727
PMCID: PMC9103024
DOI: 10.3390/jcm11092603

Review

Robotic Living Donor Right Hepatectomy: A Systematic Review and Meta-Analysis

Eddy P Lincango Naranjo et al. J Clin Med. 2022.

. 2022 May 5;11(9):2603.

doi: 10.3390/jcm11092603.

Authors

Affiliations

¹ Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55905, USA.
² Department of Teaching and Research, Hospital Vozandes Quito, Quito 170521, Ecuador.
³ Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.
⁴ Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, 01067 Dresden, Germany.
⁵ Medical School, Universidad Internacional del Ecuador, Quito 170411, Ecuador.
⁶ Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany.
⁷ Department of General and Visceral Surgery, Medical Campus Chemnitz of the TU Dresden, 01307 Dresden, Germany.
⁸ Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, CA 94305, USA.
⁹ Medical School, Universidad de las Américas, Quito 170503, Ecuador.
¹⁰ Division of Metabolic and Weight Loss Surgery, Hospital General San Francisco IESS, Quito 170111, Ecuador.
¹¹ Division of Metabolic and Weight Loss Surgery, Hospital Metropolitano, Quito 170521, Ecuador.
¹² Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru.
¹³ Mayo Clinic Libraries, Mayo Clinic, Rochester, MN 55905, USA.
¹⁴ Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
¹⁵ 1st Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
¹⁶ Division of Metabolic and Weight Loss Surgery, Department of Surgery, Duke University, Durham, NC 27705, USA.
¹⁷ Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Stanford University, Stanford, CA 94305, USA.
¹⁸ Frimley Park Hospital, Frimley Health NHS Foundation Trust, Surrey GU16 7UJ, UK.
¹⁹ Department of Surgery, Duke University, Durham, NC 27705, USA.

PMID: 35566727
PMCID: PMC9103024
DOI: 10.3390/jcm11092603

Abstract

The introduction of robotics in living donor liver transplantation has been revolutionary. We aimed to examine the safety of robotic living donor right hepatectomy (RLDRH) compared to open (ODRH) and laparoscopic (LADRH) approaches. A systematic review was carried out in Medline and six additional databases following PRISMA guidelines. Data on morbidity, postoperative liver function, and pain in donors and recipients were extracted from studies comparing RLDRH, ODRH, and LADRH published up to September 2020; PROSPERO (CRD42020214313). Dichotomous variables were pooled as risk ratios and continuous variables as weighted mean differences. Four studies with a total of 517 patients were included. In living donors, the postoperative total bilirubin level (MD: −0.7 95%CI −1.0, −0.4), length of hospital stay (MD: −0.8 95%CI −1.4, −0.3), Clavien−Dindo complications I−II (RR: 0.5 95%CI 0.2, 0.9), and pain score at day > 3 (MD: −0.6 95%CI −1.6, 0.4) were lower following RLDRH compared to ODRH. Furthermore, the pain score at day > 3 (MD: −0.4 95%CI −0.8, −0.09) was lower after RLDRH when compared to LADRH. In recipients, the postoperative AST level was lower (MD: −0.5 95%CI −0.9, −0.1) following RLDRH compared to ODRH. Moreover, the length of stay (MD: −6.4 95%CI −11.3, −1.5) was lower after RLDRH when compared to LADRH. In summary, we identified low- to unclear-quality evidence that RLDRH seems to be safe and feasible for adult living donor liver transplantation compared to the conventional approaches. No postoperative deaths were reported.

Keywords: liver transplantation; meta-analysis; robot; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram of the study selection process.

**Figure 2**
Risk ratio of postoperative Clavien–Dindo complications and mortality in recipients and donors. Suppl figs can be found in Github, please refer to Section 2.8.

**Figure 3**
Mean differences in donors’ and recipients’ postoperative characteristics—part 1. Suppl figs can be found in Github, please refer to Section 2.8.

**Figure 4**
Mean difference in donors’ and recipients’ postoperative characteristics—part 2. Suppl figs can be found in Github, please refer to Section 2.8.

See this image and copyright information in PMC

References

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Robotic Living Donor Right Hepatectomy: A Systematic Review and Meta-Analysis

Affiliations

Robotic Living Donor Right Hepatectomy: A Systematic Review and Meta-Analysis

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources