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RESEARCH PRODUCT

Comparative Study of the Initial Experience in Performing Robotic and Laparoscopic Right Hepatectomy with Technical Description of the Robotic Technique

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<b><i>Background:</i></b> Despite potential benefits of robotic liver surgery, it is still considered a “development in progress” technique. <b><i>Methods:</i></b> The outcomes of 14 patients undergoing robotic right hepatectomy were analyzed and compared with the results of 20 laparoscopic right hepatectomies consecutively performed by the same young surgeon. <b><i>Results:</i></b> The overall mean operative time was less in robotic arm (425 ± 139 vs. 565.18 ± 183.73, <i>p</i> = 0.022) and the estimated blood loss was similar (335.15 ± 139.8 vs. 423.95 ± 205.15, <i>p</i> = 0.17); no blood transfusion was required. Two patients in robotic group and 5 in laparoscopic group (<i>p</i> = 0.454) underwent conversion to open surgery; the overall morbidity was 21.4 and 15% in studied arms, respectively (<i>p</i> = 0.634). Pathology reports showed a mean surgical margin of 26.02 ± 3.9 in robotic arm, 28.76 ± 4.6 for laparoscopic, (<i>p</i> = 0.079) and we achieved a R0 resection rate of 91.66 and 85%, respectively. Reoperation and 90-days mortality rate were both null in robotic arm. One patient in laparoscopic group was reoperated due to postoperative hemorrhage. One-year overall and disease free-survival rate were 92.3 and 84.6%, respectively in robotic arm and 90 and 85% in laparoscopic arm. <b><i>Conclusions:</i></b> Robotic right hepatectomy is a safe and feasible technique providing promising short-term outcomes and oncological results also in the initial phase of learning curve.