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DOES ROBOTIC SYSTEM HAVE ADVANTAGES OVER LAPAROSCOPIC SYSTEM FOR DISTAL PANCREATECTOMY?

Sarang Hong, Madkhali Ahmad, Ki Byung Song, Chung Hyeun Ma, Song Cheol Kim, Young-Joo Lee, Dae Wook Hwang, Jae Hoon Lee, Sang Hyun Shin, Jaewoo Kwon, Seunghyun Hwang, Guisuk Park, Yejong Park, Seung Jae Lee, Kwang-Min Park. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea

Background: Laparoscopic distal pancreatectomy (LDP) has been the best choice for the treatment of left-sided pancreatic lesions. Robotic systems provide an advanced surgical technique for minimally invasive surgery. Therefore, we compared the perioperative and short-term oncologic outcomes of robot-assisted LDP (RA-LDP) and conventional LDP.

Methods: A retrospective analysis was conducted of all consecutive minimally invasive distal pancreatectomy cases performed by a single surgeon at Asan Medical Center between October 2015 and October 2016.

Results: A total of 91 consecutive patients underwent minimally invasive distal pancreatectomy (LDP n = 61; RA-LDP n = 30). Most common pathologic finding was pancreatic ductal adenocarcinomas (36cases). There was no in-hospital mortality or cases of conversion to open surgery in this study. Spleen-preserving approach was performed more often in the RA-LDP (95%) than in the LDP (77.8%) groups (p = 0.132). Both groups showed no difference in complication rate (10% vs. 18%), postoperative hospital stay (7.6 ± 2.6 vs. 8.4 ± 3.1 days), and readmission rate (6.7% vs. 3.3%). Operative time was significantly longer in the RA-LDP group (171.2 ± 50.4 vs. 144.3 ± 50.1, p = 0.02). In a subgroup analysis on patients with completed spleen-preserving approach, there was no significant difference in operative time between the RA-LDP and LDP groups (165 ± 56.3 vs. 139 ± 36.5 min, p = 0.14). Both groups showed no significant differences in the total number of lymph nodes, number of positive lymph nodes, tumor differentiation, tumor stage, and resection margins.

Conclusions: RA-LDP is a safe and feasible approach that has an advantage of performing spleen-preserving distal pancreatectomy, with perioperative and short-term oncologic outcomes comparable to those of LDP.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86929

Program Number: P796

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

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