Robotic versus laparoscopic resection of liver tumours

Background: There are scant data in the literature regarding the role of robotic liver surgery. The aim of the present study was to develop techniques for robotic liver tumour resection and to draw a comparison with laparoscopic resection. Methods: Over a 1-year period, nine patients underwent robotic resection of peripherally located malignant lesions measuring < 5 cm. These patients were compared prospectively with 23 patients who underwent laparoscopic resection of similar tumours at the same institution. Statistical analyses were performed using Student's t-test, chi(2)-test and Kaplan-Meier survival. All data are expressed as mean +/- SEM. Results: The groups were similar with regards to age, gender and tumour type (P = NS). Tumour size was similar in both groups (robotic -3.2 +/- 1.3 cm vs. laparoscopic -2.9 +/- 1.3 cm, P = 0.6). Skin-to-skin operative time was 259 +/- 28 min in the robotic vs. 234 +/- 17 min in the laparoscopic group (P = 0.4). There was no difference between the two groups regarding estimated blood loss (EBL) and resection margin status. Conversion to an open operation was only necessary in one patient in the robotic group. Complications were observed in one patient in the robotic and four patients in the laparoscopic groups. The patients were followed up for a mean of 14 months and disease-free survival (DFS) was equivalent in both groups (P = 0.6). Conclusion: The results of this initial study suggest that, for selected liver lesions, a robotic approach provides similar peri-operative outcomes compared with laparoscopic liver resection (LLR).