Evidence map›Paper›PMID 39966129›Full record

ArticleSurgical endoscopy2025

One hundred and fifty-two robotic hepatectomies at a North American hepatobiliary program: Evolution of practice, learning curve, appraisal of outcomes, and cost analysis.

J Hawksworth, P Radkani, S Shoucair, S Gogna, T Fishbein, E Winslow

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

J HawksworthDepartment of Abdominal Organ Transplant and Hepatobiliary Surgery, Columbia University Irving Medical Center, New York, USA. jh4824@cumc.columbia.edu.ORCID 0000-0001-9432-8258
P RadkaniMedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington DC, USA.
S ShoucairDepartment of Abdominal Transplantation, Cleveland Clinic, Cleveland, OH, USA.
S GognaMedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington DC, USA.
T FishbeinMedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington DC, USA.
E WinslowMedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington DC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn North America, the majority of hepatectomies are still performed in traditional open fashion. Robotic hepatectomy may facilitate a minimally invasive approach to liver resection.

objectivesWe report a single-center experience with the wide adaptation of robotic hepatectomy over a 5-year period. MATERIALS AND

methodsRetrospective analysis of a prospectively maintained database of all hepatectomies (n = 334) was performed at our institution from January 2018 to January 2023. This included 164 open, 18 laparoscopic, and 152 robotic hepatectomies. Propensity score matching (PSM) was used to match open (n = 100) to robotic (n = 100) hepatectomy cases by demographics and case complexity. Standard statistics were used to compare 90-day outcomes, including textbook outcome after liver surgery (TOLS), and cost. CUSUM curves were used to determine the learning curve for major hepatectomy.

resultsDuring the study period, laparoscopic hepatectomy was phased out and robotic hepatectomy became the predominant approach. The median IWATE score for the robotic cases was 8 ± 2 and 39% were major hepatectomies. The learning curve for robotic right hepatectomy was 15 cases. When PSM cases were compared, while operative time was longer, blood loss and transfusion, intraoperative incidents, overall and major morbidity, bile leaks, post-hepatectomy liver failure, hypoxia requiring supplemental oxygen, reoperation, ICU utilization, and length of stay were significantly lower in the robotic group. There was no difference in positive margins or 90-day mortality. Robotic hepatectomy was associated with significantly higher TOLS compared to open hepatectomy (85% versus 64%, p < 0.001) and on multivariate analysis, only a robotic hepatectomy approach was independently associated with achieving TOLS (OR 3.3, (1.62-6.67) 95% CI)). The lower ICU utilization and length of stay accounted for a significantly lower overall hospital cost for robotic compared to open hepatectomy despite a higher operating room cost.

conclusionWe describe the successful implementation of robotic hepatectomy at our institution with favorable outcomes and cost.

Indexed as

HepatectomyLearning CurveRobotic Surgical ProceduresAdultAgedBlood Loss, SurgicalCosts and Cost AnalysisFemaleHumansLaparoscopyLength of StayMaleMiddle AgedNorth AmericaOperative TimePostoperative ComplicationsDavinciLearning curveMinimally invasive hepatectomyTextbook outcome after liver surgery

Identifiers

PMID39966129

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.