Gastroenterology & Hepatology


A Current Status between Laparoscopic and Robotic Resection of Pancreatic Malignant: A Systematic Review

Maher Hendi, Bin Zhang, Ke chen, Yu Pan, Yiping Mou.

Background: Laparoscopic and Robotic approaches have become increasingly used for pancreatic surgery. The aim of this study is to evaluate compile and evaluate existing literature on the comparison of laparoscopic pancreatic surgery and robotic pancreatic surgery in the resection of Pancreatic neoplasms. The outcomes of each technique were quantified using meta-analysis. 

Study Design: A systematic review of articles in both PubMed and Embase comparing laparoscopic and robotic colorectal procedures was performed. Approaches were evaluated in terms of operative time, length of stay, estimated blood loss, conversion, number of lymph nodes harvested, and mobidity and mortality and pancreatic fistula. Mean net differences and effect of each group.

Results: 232 were full-text articles were identified, and 47 met the inclusion criteria, representing 2753 patients: 690 patients who underwent robotic pancreatic surgery procedures and 2063 patients who underwent laparoscopic pancreatic surgery procedure. Operative time for the robotic approach was 20-45 minutes longer. The robotic group had lower estimated blood loss (57 ml), and patients were 1.85 times more likely to be converted procedure and average length of stay in hospital (14,395 vs 11.85) laparoscopic group was longer then robotic. But there was no real difference between the 2 groups in terms of number of day. There was no much real difference between groups with respect to number of lymph nodes harvested, mortality, or morbidity rate.

Conclusions: The laparoscopic and robotic approach to pancreatic surgery is as safe and similar outcomes for both procedures. Further the robotic approach tended to have longer operating times, less blood loss, and a higher rate of conversion to an open procedure compared with laparoscopic procedure. On the basis of the findings of this meta-analysis, there does not appear to be any clear advantage of a robotic approach over a laparoscopic one for pancreatic surgery.