Minimally invasive left lateral sectionectomy robot vs laparoscopy

Objective: To assess the feasibility and the safety of robotic assisted liver resection (RALR) for tumors confined to the left liver and to compare it to the laparoscopic approach. Background: Laparoscopic liver resection is considered a standard of practice for left lateral sectionectomy. RALR is increasingly reported in the literature, but its true benefit remains unclear. Methods: Between 1997 and 2014, a total of 96 consecutive patients underwent minimally invasive left lateral sectionectomy. Patients were divided into two groups: laparoscopic and robotic groups. Clinicopathological characteristics and operative outcomes were compared. Results: There were 80 laparoscopic left lateral sectionectomies. Robotic left lateral sectionectomy was performed in 16 cases. Mean tumor size was not different between the two groups: 54.5±36.8 mm and 36.4±19.5 mm, respectively (P = 0.06). Patients who had robotic surgery had a longer operative time (189.9±86.9 min) as compared to those who had laparoscopic surgery (161.9±50.9 min; p = 0.097). Robotic surgery had a higher rate of conversion to open surgery: 12.5% vs. 2.5% (p = 0.068). Postoperative complications were similar between the robotic and laparoscopic groups (11% in group 1 vs. 12.5% in group 2; p = 0.77). Conclusion: Robotic left lateral sectionectomy is still associated with higher rate of conversion and longer operation time. This study suggests that robotic left lateral sectionectomy is feasible and reproducible, but specific education in advanced robotic surgery is however required.