Minimally invasive liver resection: robotic versus laparoscopic left lateral sectionectomy.
BACKGROUND
The purpose of this study was to compare the clinical and economic outcomes of robotic versus laparoscopic left lateral sectionectomy (LLS).


METHODS
A retrospective analysis was made comparing robotic (n = 11) and laparoscopic (n = 18) LLS performed at the University of Pittsburgh Medical Center between January 2009 and July 2011. Demographic data, operative, and postoperative outcomes were collected.


RESULTS
Demographic and tumor characteristics of robotic and laparoscopic LLS were similar. There were also no significant differences in operative outcomes including estimated blood loss and operating room time. Patients undergoing robotic LLS had more admissions to the ICU (46 versus 6 %), increased rate of minor complications (27 versus 0 %), and longer lengths of stay (4 versus 3 days). There were no significant differences in major complication rates or 90-day mortality. The cost of robotic and laparoscopic LLS was not significantly different when only considering direct costs ($5,130 versus $4,408, p = 0.401). However, robotic LLS costs were significantly greater when including indirect costs, which were estimated to be $1,423 per robotic case ($6,553 versus $4,408, p = 0.021).


CONCLUSIONS
Robotic LLS yields slightly inferior clinical outcomes and increased cost compared to the laparoscopic approach.
Division of Hepatobiliary and Pancreatic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Vignesh
V
Packiam
David L
DL
Bartlett
Samer
S
Tohme
Srinevas
S
Reddy
J Wallis
JW
Marsh
David A
DA
Geller
Allan
A
Tsung
D005260:Female; D006498:Hepatectomy / Q000191:economics* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics / Q000191:economics*; D016896:Treatment Outcome