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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2015, Vol. 9 Issue (3) : 356-360     DOI: 10.1007/s11684-015-0404-0
Robotic distal pancreatectomy versus conventional laparoscopic distal pancreatectomy: a comparative study for short-term outcomes
Eric C. H. Lai(),Chung Ngai Tang
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China
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Robotic system has been increasingly used in pancreatectomy. However, the effectiveness of this method remains uncertain. This study compared the surgical outcomes between robot-assisted laparoscopic distal pancreatectomy and conventional laparoscopic distal pancreatectomy. During a 15-year period, 35 patients underwent minimally invasive approach of distal pancreatectomy in our center. Seventeen of these patients had robot-assisted laparoscopic approach, and the remaining 18 had conventional laparoscopic approach. Their operative parameters and perioperative outcomes were analyzed retrospectively in a prospective database. The mean operating time in the robotic group (221.4 min) was significantly longer than that in the laparoscopic group (173.6 min) (P = 0.026). Both robotic and conventional laparoscopic groups presented no significant difference in spleen-preservation rate (52.9% vs. 38.9%) (P = 0.505), operative blood loss (100.3 ml vs. 268.3 ml) (P = 0.29), overall morbidity rate (47.1% vs. 38.9%) (P = 0.73), and post-operative hospital stay (11.4 days vs. 14.2 days) (P = 0.46). Both groups also showed no perioperative mortality. Similar outcomes were observed in robotic distal pancreatectomy and conventional laparoscopic approach. However, robotic approach tended to have the advantages of less blood loss and shorter hospital stay. Further studies are necessary to determine the clinical position of robotic distal pancreatectomy.

Keywords distal pancreatectomy      pancreatic neoplasm      robotic surgery     
Corresponding Authors: Eric C. H. Lai   
Just Accepted Date: 08 July 2015   Online First Date: 21 August 2015    Issue Date: 26 August 2015
URL:     OR
Variables Robotic approach (n?=?17) Conventional laparoscopic approach (n?=?18) P value
Gender (male: female) 10:7 4:14 0.035
Mean age (year) 61.2±10.4 (SD) 63.2±17.9 (SD) 0.701
The American Society of Anesthesiologists (ASA) Scores12 611 414 0.471
Mean body mass index (BMI) 24.1±2.3 (SD) 25.7±2.7 (SD) 0.067
Malignant pathology (%) 4 (23.5%) 2 (11.1%) 0.402
Type of pathology (n)Ca pancreasMetastasis from Ca colonSerous cyst adenomaMucinous cystic tumorPseudopapillary tumorAcinar cell csytadenomaNeuroendocrine tumorIntraductal papillary mucinous neoplasm (IPMN)Chronic pancreatitisPseudocyst 3162004100 2064112012 \
Tab.1  Patients’ characteristics and pathologies (one patient in laparoscopic group had double pathologies)
Variables Robotic approach (n?=?17) Conventional laparoscopic approach (n?=?18) P value
Spleen preservation (%) 9 (52.9%) 7 (38.9%) 0.505
Mean operation time (min) 221.4±73.2 (SD) 173.6±45.6 (SD) 0.026
Mean blood loss (ml) 100.3 (range, 10-300) 268.3 (range, 20-2600) 0.29
Morbidity (No. of patients with complications) (%) 8 (47.1%) 7 (38.9%) 0.73
Type of complication (%)Pancreatic fistulaPseudoaneurysm with bleedingIleusCollectionWound infection 7 (41.2%)1 (5.9%)1 (5.9%)1 (5.9%)1 (5.9%) 6 (33.3%)0 (0%)0 (0%)3 (16.7%)1 (5.6%) 0.730.470.470.601.0
30-day mortality (%) 0 (0%) 0 (0%) \
Mean length of stay (day) 11.4±6.9 (SD) 14.2±14 (SD) 0.46
Tab.2  Surgical outcomes
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