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16-01-2024 | Cholecystectomy | Original Article

Outcomes of Robotic Surgery in a Single-institution, High-volume Hepatobiliary Oncology Unit

Authors: Kunal Nandy, Shraddha Patkar, Gurudutt Varty, Tanvi Shah, Mahesh Goel

Published in: Indian Journal of Surgical Oncology | Special Issue 2/2024

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Abstract

Hepatobiliary surgery has traditionally been performed via an open approach. With the advent of robotic surgery, the minimal access approach in hepatobiliary oncology has gained impetus due to its technical superiority and favorable learning curve over laparoscopy. We present our experience with the Da Vinci Xi system in hepatobiliary oncology. This is a retrospective study from a prospectively maintained database. All patients who underwent surgery between June 2015 and July 2023 for suspected gallbladder cancer and primary or metastatic liver tumors were included. After excluding all inoperables and conversions, a total of 92 patients were included for analysis. There was a conversion rate of 15.6% (17 of 109 patients). Sixty-four (69.6%) patients underwent surgery for gallbladder-related pathologies that included 39 (60.9%) radical cholecystectomies, 24 (37.5%) simple cholecystectomies, and 1 (0.01%) revision cholecystectomy. Twenty-eight patients underwent surgeries for primary or metastatic liver tumors, which included 25 (92.9%) minor and 2 (7.1%) major hepatectomies. Significant morbidity (Clavien–Dindo grade III or more) was seen in 8 (8.6%). There was no postoperative mortality. In the group with gallbladder cancer, the median lymph nodal yield was 7 (2–22) in patients who underwent lymph nodal dissection. The median follow-up was 63.9 (0.49–100.67) (IQR = 37.76) months. The 5-year OS and DFS were 76.4 and 71.3%, respectively. Robotic hepatobiliary surgery is feasible and can be performed safely after adequate training. Patient selection is of utmost importance and is the key to establishing a robust robotic hepatobiliary oncosurgery program.
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Metadata
Title
Outcomes of Robotic Surgery in a Single-institution, High-volume Hepatobiliary Oncology Unit
Authors
Kunal Nandy
Shraddha Patkar
Gurudutt Varty
Tanvi Shah
Mahesh Goel
Publication date
16-01-2024
Publisher
Springer India
Published in
Indian Journal of Surgical Oncology / Issue Special Issue 2/2024
Print ISSN: 0975-7651
Electronic ISSN: 0976-6952
DOI
https://doi.org/10.1007/s13193-024-01873-6

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