Revisiting the potential advantage of robotic surgical system in spleen-preserving distal pancreatectomy over conventional laparoscopic approach.

BACKGROUND

This study aimed to compare success rate of spleen preservation between robotic and laparoscopic distal pancreatectomy (DP).

METHODS

Between November 2007 and March 2018, forty-one patients underwent the conventional laparoscopic DP (Lap group) and the other 37 patients underwent robotic DP (Robot group). The perioperative clinicopathologic variables were compared.

RESULTS

The robotic procedure was chosen by younger patients compared to conventional laparoscopic surgery (42.9±14.0 51.3±14.6 years, P=0.016). The mean operation time was longer (313 246 min, P=0.000), but the mean tumor size was smaller in Robot group (2.7±1.2 4.2±3.3 cm, P=0.018). The overall spleen-preserving rate was higher in the Robot group (91.9% 68.3%, P=0.012). However, with accumulating laparoscopic experiences (after 16th case), the statistical differences in spleen preservation rate between the Robot and Lap groups had diminished (P=0.428).

CONCLUSIONS

The present results suggest a robot can be helpful to save the spleen during DP for benign and borderline malignancy. However, a surgeon highly experienced in the laparoscopic approach can also produce a high success rate of spleen preservation, similar to that shown with the robotic approach.