☆ 4.4 Review

Robotic versus laparoscopic distal pancreatectomy on perioperative outcomes: a systematic review and meta-analysis

UPDATES IN SURGERY (2023)

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Summary: This study identified benchmark cutoffs for outcome parameters in robotic distal pancreatectomy (DP) and compared them with laparoscopic and open DP. The results showed that robotic DP had superior postoperative outcomes compared with laparoscopic and open DP, indicating it may become the preferred approach in minimally invasive DP.

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Summary: This study investigated the efficacy and feasibility of robotic distal pancreatectomy (RDP) for pancreatic ductal adenocarcinoma (PDAC). The results showed that RDP had longer operative time, higher cost, but a higher likelihood of achieving R0 margins compared to laparoscopic distal pancreatectomy (LDP). The postoperative survival was similar between the two groups.

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Comparison of infectious complications after spleen preservation versus splenectomy during laparoscopic distal pancreatectomy for benign or low-grade malignant pancreatic tumors: A multicenter, propensity score-matched analysis

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Summary: The study aimed to evaluate the advantages of spleen preservation during laparoscopic distal pancreatectomy (LDP) for preventing infectious complications. By comparing the data of postoperative infectious complications in different groups, the study found that spleen preservation could lower the risk of infectious complications, but the risk may vary according to the surgeon's experience.

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Impact of the transection plan on postoperative pancreatic fistulas occurring after robot-assisted distal pancreatectomy for nonmalignant pancreatic neoplasms

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Summary: This study investigated the impact of remnant pancreas and other perioperative factors on postoperative pancreatic fistula (POPF) occurring after robot-assisted distal pancreatectomy (RDP) for nonmalignant pancreatic neoplasms. The results showed that a transection plan involving the tail of the pancreas and spleen preservation independently increased the incidence of POPF. The length of the remnant pancreas was also found to be a risk factor for POPF.

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A comparison of robotic versus laparoscopic distal pancreatectomy: Propensity score matching analysis

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Summary: Robotic distal pancreatectomy is more expensive but feasible, with a higher likelihood of completing the planned operation and a lower open conversion rate.

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Performance with robotic surgery versus 3D-and 2D-laparoscopy during pancreatic and biliary anastomoses in a biotissue model: pooled analysis of two randomized trials

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Summary: This study compared the postoperative outcomes and costs between robotic-assisted distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP), and explored the learning curve of RDP. The results showed that the RDP group had shorter hospital stay, postoperative first exhaust time, and first feeding time compared to the LDP group, but the cost of RDP was higher. The study also found that the learning curve of RDP significantly decreased after completing 32 cases.

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Propensity-Score Matched Analyses Comparing Clinical Outcomes of Minimally Invasive Versus Open Distal Pancreatectomies: A Single-Center Experience

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Impact of spleen preservation on the incidence of postoperative pancreatic fistula after distal pancreatectomy: Is less more?

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Summary: This study aimed to investigate the impact of splenectomy on perioperative outcome in patients undergoing distal pancreatectomy. The results showed that preservation of the spleen reduces the occurrence of postoperative pancreatic fistula and leads to shorter hospital stay and fewer readmissions.

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Benchmarking of minimally invasive distal pancreatectomy with splenectomy: European multicentre study

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Summary: The study aimed to assess the best achievable outcomes in minimally invasive distal pancreatectomy with splenectomy using the Achievable Benchmark of Care method. The results showed that the benchmark values obtained using the ABC method represented optimal outcomes, including low complication rates and zero mortality. These benchmarks can be used to set standards and improve patient outcomes.

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Cost-effectiveness and quality of life analysis of laparoscopic and robotic distal pancreatectomy: a propensity score-matched study

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Summary: This study analyzed the Quality of Life (QoL) and cost-effectiveness of laparoscopic (LDP) versus robotic distal pancreatectomy (RDP), finding that robotic surgery was associated with improvement in specific domains of QoL but higher costs relative to laparoscopic surgery. Robotic surgery may be more cost-effective when a willingness to pay of more than 4800 Euros/QALY was accepted, indicating potential benefits in certain circumstances.

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Summary: The study compared the outcomes of different surgical approaches (RDP, LDP, and ODP) in the treatment of PDAC patients, showing no significant differences in baseline characteristics and postoperative complications among the three approaches. The different surgical approaches did not have a significant impact on overall survival rates.

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Learning curve of laparoscopic and robotic pancreas resections: a systematic review

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Summary: This study provides a detailed summary of the current evidence on the learning curve in minimally invasive pancreatic resection, showing no significant difference between the learning curve for robotic pancreaticoduodenectomy versus laparoscopic pancreaticoduodenectomy, and robotic distal pancreatectomy versus laparoscopic distal pancreatectomy. These findings are limited by the retrospective nature and heterogeneity of the studies published to date.

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Giacomo Deiro et al.

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Nawid Najafi et al.

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Meta-analysis of short-term outcomes comparing robot-assisted and laparoscopic distal pancreatectomy

Yong-hao Hu et al.

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Robot-assisted distal pancreatectomy improves spleen preservation rate versus laparoscopic distal pancreatectomy for benign and low-grade malignant lesions of the pancreas

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Short-term and long-term outcomes after robot-assisted versus laparoscopic distal pancreatectomy for pancreatic neuroendocrine tumors (pNETs): a multicenter comparative study

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