Robotic vs open pancreatectomy. Case matched study

Abstract

Objective: Robotic surgery is gaining worldwide acceptance among surgeons. However, in the pancreatic field, its advantages are still under investigation. The aim of this study is to reports our early experience with robotic pancreatectomies and compare with the conventional open approach. Methods: Our robotic pancreatectomies experience was compared to a case-matched series of open pancreatectomies patients at the same center. Matching was according to benign/malignant diagnosis and main preoperative data. Patient data were obtained retrospectively. The main outcomes and measures were operative time, estimated blood loss, conversion rate (robotic to open), resection margin size, complication rates, stay length, ICU stay length, readmission rate, and 90-day mortality rate. Results: Forty-six robotic pancreatectomies were performed in 2011–2016 at the Sanchinarro Hospital. There were 15 duodenal pancreatectomies (DP), 21 distal pancreatectomies (DP) and 9 pancreatic enucleations (PE). Compared to 47 matched patients who underwent open pancreatectomies (17 DP, 21 PD, 9 PE), there was a higher mean operative of time in the robotic group (Robotic: 378 min, Open: 192 min, p=0.02), a lower median estimated blood loss (Robotic: 300 ml, Open: 525 ml, p=0.03) and a slight shorter mean hospital stay in the robotic group. There was a 15.2 % conversion rate in the robotic group. Post-operative complication rate and margin status, as well, were similar in both groups. Conclusion: Robotic pancreatectomy is safe and effective. Increasing experience will allow definition of which patient and type of tumor can be performed robotically, and will enable optimization of outcomes. Further studies are needed to confirm our early results.