ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2021
Minimally Invasive Hepatectomy in North America: Laparoscopic Versus Robotic.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- From laparoscopy to robotics in living donor hepatectomy: a systematic review and meta-analysis of comparative outcomes.Journal of robotic surgery · 2026Pooled it
- Robotic versus laparoscopic hepatectomy: meta-analysis of propensity-score matched studies.BJS open · 2025Pooled it
- Tracking Technological Change in Liver Surgery: Robotic Adoption and Case-Mix Evolution in the I Go MILS Registry.Cancers · 2026Article
- Robotic Versus Laparoscopic Liver Resection: A Nationwide Propensity Score Matched Analysis.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Evolution of minimally invasive liver surgery in France over the last decade.Surgical endoscopy · 2024Article
- Role of ablation therapy in conjunction with surgical resection for neuroendocrine tumors involving the liver.World journal of gastrointestinal surgery · 2024Article
- Early outcomes of single-port robotic left lateral sectionectomy in patients with hepatic tumor.Annals of surgical treatment and research · 2024Article
- Advances in minimally invasive liver surgery.Northern clinics of Istanbul · 2024Review
- Procedure-specific risks of robotic simultaneous resection of colorectal cancer and synchronous liver metastases.Journal of robotic surgery · 2023Article
- Robotic versus laparoscopic liver resections for hepatolithiasis: an international multicenter propensity score matched analysis.Surgical endoscopy · 2023Article
- Major hepatectomy in elderly patients: possible benefit from robotic platform utilization.Surgical endoscopy · 2023Article
- Practice variation and outcomes of minimally invasive minor liver resections in patients with colorectal liver metastases: a population-based study.Surgical endoscopy · 2023Article
- Perioperative outcomes of robot-assisted versus laparoscopic liver resection for cavernous hemangioma: a propensity score matching study.Surgical endoscopy · 2023Article
- Robotic major and minor hepatectomy: critical appraisal of learning curve and its impact on outcomes.Surgical endoscopy · 2023Article
- Cost analysis of robotic versus open hepatectomy: Is the robotic platform more expensive?Journal of robotic surgery · 2022Article
- Comparison of robotic and laparoscopic liver resection in ordinary cases of left lateral sectionectomy.Surgical endoscopy · 2022Article
- Robotic and laparoscopic right anterior sectionectomy and central hepatectomy: multicentre propensity score-matched analysis.The British journal of surgery · 2022Article
- International multicentre propensity score-matched analysis comparing robotic versus laparoscopic right posterior sectionectomy.The British journal of surgery · 2021Article
Corrections and comments
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Authors and funding
4 authors.
Funding
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Abstract
backgroundMinimally invasive hepatectomy has been shown to be associated with improved outcomes when compared with open surgery. However, data comparing laparoscopic and robotic hepatectomy is lacking and limited to single-center studies.
methodsPatients undergoing major (≥ 3 segments) or partial (≤ 2 segments) hepatectomy were identified in the 2014-2017 ACS-NSQIP hepatectomy targeted database. Patients undergoing laparoscopic and robotic approaches were compared, and propensity score matching was utilized to adjust for bias.
resultsOf 3152 minimally invasive hepatectomies (MIHs), 86% (N = 2706) were partial and 14% (N = 446) were major. The laparoscopic approach was utilized in 92% of patients (N = 2905) and 8% were performed robotically (N = 247). The percentage of MIHs increased over time (p < 0.01). After matching, 240 were identified in each cohort. Compared with the robotic approach, patients undergoing laparoscopic hepatectomy had a significantly higher conversion rate (23% vs. 7.4%) but had shorter operative time (159 vs. 204 min) (p < 0.001). Laparoscopic cases undergoing an unplanned conversion to open were associated with increased morbidity (p < 0.001), but this difference was not observed in robotic cases. Both MIH approaches had low mortality (1.0%, p = 1.00), overall morbidity (17%, p = 0.47), and very short length of stay (3 days, p = 0.80).
conclusionMinimally invasive hepatectomy is performed primarily for partial hepatectomies. Laparoscopic hepatectomy is associated with a significantly higher conversion rate, and converted cases have worse outcomes. Both minimally invasive approaches are safe with similar mortality, morbidity, and a very short length of stay. Graphical Abstract.
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