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Surgical Endoscopy
Published in: Surgical Endoscopy 11/2015

01-11-2015

A prospective non-randomised single-center study comparing laparoscopic and robotic distal pancreatectomy

Authors: Giovanni Butturini, Isacco Damoli, Lorenzo Crepaz, Giuseppe Malleo, Giovanni Marchegiani, Despoina Daskalaki, Alessandro Esposito, Sara Cingarlini, Roberto Salvia, Claudio Bassi

Published in: Surgical Endoscopy | Issue 11/2015

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Abstract

Background

Laparoscopic distal pancreatectomy (LDP) is increasing in popularity thanks to the benefits that have been recently demonstrated by many authors. The Da Vinci® Surgical System could overcome some limits of laparoscopy, helping the surgeons to perform safer and faster difficult procedures. Nowadays, prospective clinical trials comparing LDP to robotic distal pancreatectomy (RDP) are lacking. The aim of this study is to present a prospective comparison between the two techniques.

Methods

Since November 2011, all patients suitable for minimally invasive distal pancreatectomy were assigned either to LDP or RDP, depending on the availability of the Da Vinci® Surgical System for our Surgical Unit. Demographics, clinical, and intra- and postoperative data, including estimated costs of the procedure, were prospectively collected. Follow-up included cross-sectional imaging ended on April 2014.

Results

Twenty-two patients underwent RDP and 21 LDP; patients’ characteristics were similar. The median operative time was longer and procedures’ cost was double in RDP group. The conversion to open rate and the median length of postoperative hospital stay were 4.5 % and 7 days, respectively, in both groups. Pancreatic fistula developed in 57.1 % (12/21) and 50 % (11/22) of LDP and RDP, respectively (p = 0.870), being grade A the most frequent. Mortality was nil and an R0 resection was achieved in all Patients. The overall number of lymph nodes harvested was similar between the two groups.

Conclusions

Both RDP and LDP are valid techniques for the treatment of distal pancreatic tumors. The advantages of RDP are claimed by many but still under investigation. Some of these advantages are more subjective than objective, and it seems difficult to demonstrate a real superiority of one technique over the other in a standardized fashion. In our experience, laparoscopy has not been abandoned in favor of the robot: we continue to perform both approaches choosing upon single patient’s characteristics.
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Metadata
Title
A prospective non-randomised single-center study comparing laparoscopic and robotic distal pancreatectomy
Authors
Giovanni Butturini
Isacco Damoli
Lorenzo Crepaz
Giuseppe Malleo
Giovanni Marchegiani
Despoina Daskalaki
Alessandro Esposito
Sara Cingarlini
Roberto Salvia
Claudio Bassi
Publication date
01-11-2015
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 11/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-4043-3

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